A holistic approach to treatment offers the best outcomes, according to SAMHSA. This approach recognizes that there are multiple pathways to recovery, and recovery is built on the multiple strengths, talents and inherent values of the individual.
Holistic treatment addresses a wide range of issues related to physical, mental and spiritual health and well-being. It involves a combination of traditional “talk” therapies and research-based experiential, or “hands-on,” therapies. This combination of therapies helps people in treatment look at a variety of issues from many different angles for meaningful, whole-person healing.
Experiential therapies support personal growth and empowerment, and they’re widely used in high-quality addiction treatment programs.
Experiential Therapy in Addiction Treatment
Talk therapies commonly used in treatment include cognitive-behavioral therapy, or CBT, which helps individuals identify self-destructive thought and behavior patterns and develop new, healthier ways of thinking and behaving.
CBT helps people work through trauma and other issues that often underlie an addiction. It helps them develop essential coping skills for dealing with negative emotions, cravings, stress and other important relapse triggers.
- Develop greater self-awareness through observing how they respond emotionally and behaviorally while performing an engaging or purposeful activity.
- Tap into emotions that are difficult to express or make sense of.
- Access buried emotions or experiences in a safe, supportive environment.
- Recognize emotional responses that arise during certain situations in life.
- Take action to initiate meaningful life changes.
Experiential therapies are also about having fun and staying engaged in treatment. They help clients participate more fully in their recovery plan and may lead to new, healthy hobbies that increase their enjoyment of life and help them pass the time with productive pursuits.
Kolb’s Four-Stage Experiential Learning Cycle
Stage 1: Engaging in a new situation or experience in a concrete, hands-on way.
Stage 2: Actively observing the experience as it occurs and mindfully reflecting on it afterwards.
Stage 3: Conceptualizing the reflection of the experience into a new concept or idea or re-evaluating an old concept or idea based on the experience.
Stage 4: Applying the new or re-worked idea into one’s own life, letting it shape their perception of the world around them in positive ways.
Types of Experiential Therapies
These are some of the experiential therapies commonly found in addiction treatment programs.
- Recreating an experience through drawing or painting.
- Expressing emotions with color, shape and line.
- Creating an art journal for writing down reflections.
- Using art-making as a way to relieve stress and find enjoyment.
- Viewing art and discussing it in a group setting.
Art therapy helps participants express difficult emotions and synthesize past experiences through creative self-expression. According to an article published in the American Journal of Health, other benefits of art therapy include:
- Healing of emotional wounds
- Altering dysfunctional thought and behavior patterns
- Decreased denial
- Reduced ambivalence toward recovery
- Increased motivation to recover
- Increased self-awareness and self-reflection
- Reduced stress
- Reduced feelings of shame
During music therapy, the therapist engages participants in activities such as:
- Listening to music for inspiration or relaxation
- Analyzing song lyrics
- Writing songs as a form of self-expression
- Creating music with instruments or the voice
- Moving to music as a form of self-expression and stress reduction
Music therapy can reduce feelings of anxiety, depression, stress and anger. According to a study published in the Journal of Addictions Nursing, music therapy is associated with stronger motivation to change and greater engagement in treatment.
Other benefits of music therapy include helping participants:
- Achieve and maintain a positive emotional state
- Express and work through difficult emotions
- Relax and reduce stress
- Find common ground with other participants, strengthening the group as a unit
- Open communication pathways
- Enjoy a meaningful personal change
Music therapy promotes creative thinking and increases self-awareness, which are important foundations of recovery.
- Improved mood
- Reduced pain
- Reduced stress and anxiety
- Increased wellbeing
- Increased physical and mental strength and flexibility
- Better sleep
- Decreased stress
Aquatic therapies used in treatment programs include:
- Ai Chi, a water-based strengthening and relaxation practice that integrates physical, mental and spiritual energy.
- Ai Chi Ne, a program that involves working in pairs to help restore physical and emotional balance.
- Watsu, a one-on-one therapy that combines flowing moves, massage, floating and rocking to promote a relaxed state, heal the spirit and quiet the mind.
Horticultural therapy takes place outdoors in a garden setting. It engages participants in a variety of gardening activities, led by a trained horticultural therapist who helps them view gardening as a metaphor for nurturing their own growth and well-being.
Horticultural therapy helps participants make connections between gardening and their own experiences. Numerous studies over the years have uncovered the benefits of horticultural therapy, which include:
- Improved self-awareness
- A better mood
- Improvements in planning and decision-making skills
- Opportunities for self-expression and creativity
- Reduced negative emotions
- Reduced stress
According to Virginia Tech horticulture professor Diane Relf, horticultural therapy improves self-confidence, self-esteem and self-control through a re-channeling of aggressive feelings.
During equine therapy, participants are assigned a horse and learn to care for the animal, including grooming, leading, riding and feeding the horse.
For people recovering from an addiction, equine therapy provides:
- Immediate feedback, since horses can sense emotions and will respond accordingly. They serve as a mirror that reflects the emotions a participant may not be aware of.
- Opportunities for learning through both interactions with horses and therapist-led conversations and reflections.
- Trust-building exercises involving interactions between the participant and the horse and the participant and the therapist.
- An opportunity to build self-confidence and healthy relationship skills through the non-judgmental relationship with the horse.
According to the U.S. Department of Veterans Affairs, equine therapy has been shown to help individuals with trauma or PTSD reduce their symptoms and build self-esteem and self-confidence.
Michigan State University cites physical, emotional and psychosocial benefits of equine therapy, including:
- Increased strength, balance and coordination
- The development of coping skills that transfer to other life domains
- Restoring the brain’s assessment and compensation pathways
- Increased self-efficacy
- Greater awareness of issues like fear, anxiety and mistrust
During biofeedback therapy, sensors on the body record physiological functions related to the stress response and display them on a monitor. The biofeedback therapist teaches the client a number of relaxation techniques, such as deep breathing, progressive relaxation, meditation and guided imagery.
As the client practices these techniques, the monitor shows, in real time, the changes they produce, such as lower heart rate, blood pressure, muscle tension and body temperature.
Biofeedback helps clients:
- Learn to read their body’s stress cues
- Reduce stress and anxiety
- Develop psychological confidence
- Manage cravings
Neurofeedback, also known as brainwave biofeedback, is a type of biofeedback that helps clients learn to control their brain waves to normalize their rhythms and frequencies. According to an article published in the journal Applied Psychophysiology and Biofeedback, neurofeedback improves cognitive, emotional, physical and behavioral experiences.
It reverses the negative effects of drug and alcohol addiction on the brain and reduces symptoms of mental illnesses that frequently co-occur with addiction, including ADHD, anxiety, depression and obsessive-compulsive disorder.
The activities used in adventure therapy fall into categories such as:
- Initiative activities that encourage solving problems and cooperating with others
- Cooperative activities that create positive interactions and a sense of fun
- Trust and support activities that help participants learn to trust and rely on others
- High constructed elements, which are activities that take place at a height and help stimulate therapeutic emotional, cognitive and behavioral responses
- Expeditionary activities, which are extended adventure trips that last from seven to 90 days and involve intensive therapy, reflection and contemplation
Adventure therapy focuses on the individual’s treatment goals. It’s an active process that serves as a vehicle for change. A trained adventure therapist helps participants connect the lessons learned during the adventures to their own recovery. The therapist monitors participants’ stress levels and ensures that each adventurer is gaining positive momentum.
Wilderness settings provide unique opportunities for participants to:
- Improve their decision-making skills by learning to make quick decisions that affect both the group and the individual
- Practice healthy communication skills
- Cooperate with others toward a common goal
- Develop trust
- Learn coping skills such as tolerating stress, solving problems, and being comfortable with being uncomfortable
- Increase engagement in treatment
Adventure Therapy’s Five Main Concepts
According to the Association for Experiential Education, adventure therapy consists of five main components:
Direct involvement in treatment
Each participant works cooperatively with others and is fully accountable for his or her actions, which affect the whole group.
Natural and logical consequences in nature lead to higher motivation to make good personal choices.
Participants learn through real-time, firsthand experience in nature that actions have consequences. This leads to a higher level of accountability for each individual and for the group as a whole.
As the adventure unfolds, the therapist leads the group through periods of self-reflection. This allows members to develop a higher level of self-awareness as their strengths and weaknesses naturally emerge.
Relevance to future experiences
Participants in adventure therapy internalize lessons learned and apply them to future experiences. They may also relate lessons to past experiences for greater understanding and acceptance.
A study published in the journal Substance Abuse Treatment found that outdoor adventures are effective for:
- Lowering the risk of relapse
- Reducing alcohol cravings
- Reducing the frequency of negative thoughts
- Reducing the “fight or flight” stress response
According to the Institute for Outdoor Learning, other benefits of adventure therapy include:
- Relief from mental fatigue
- Better focus and concentration
- A more positive outlook
- Realistic goal-setting
- Better control over impulsive behaviors
During a typical drumming therapy session, participants enter the room and pick up a drum, which they play in any way they choose. Warm-up activities get participants comfortable with hitting the drums. Call-and-response activities connect participants with one another. Other activities include giving each participant a “solo” wherein they express their emotions with the drum. Together, the group creates improvisational music that helps them let go and enter a state of “flow.” The therapist may incorporate meditation or visualization into the session.
Drumming therapy promotes relaxation and feelings of accomplishment. It helps participants release negative emotions and fosters positive ones. It offers a sense of community and connectedness, reducing feelings of self-centeredness and isolation.
Drum therapy helps people work through emotional trauma and connect to a higher power. It promotes self-confidence and cooperation, increased body awareness and leadership and relationship-building skills.
During yoga, participants focus on their breath and the poses, which bring them into the present moment, where they’re better able to evaluate their thoughts, emotions and physical state. This type of mindfulness increases self-awareness and helps train the mind to exist in the here and now rather than dwelling on the past or worrying about the future.
Yoga is widely used in addiction treatment programs for its many benefits to people in recovery, including:
- A higher level of mindfulness
- Greater body-awareness
- Stress relief
- Reduced symptoms of post-traumatic stress disorder
- Improved stress response
- Reduced cravings
According to the American Psychological Association, yoga reduces depression and anxiety and helps to heal emotional wounds, particularly for trauma survivors.
Meditation promotes awareness of thoughts, emotions, and physical sensations. It helps individuals accept their experiences and emotions rather than suppress or fight them. Meditation promotes better choices, eases cravings and reduces the tendency to abuse drugs or alcohol during periods of stress or emotional upheaval.
An article in the journal Substance Abuse cites a large body of research that shows mindfulness meditation is effective for treating addiction.
- Reduces blood pressure and other stress responses
- Relieves pain
- Reduces anxiety and depression
- Increases self-awareness
- Reduces the stress response
- Helps individuals respond better to external events
- Promotes feelings of calm and inner peace
Meditation even changes the structures of the brain. According to research, meditation increases the volume of brain areas responsible for emotional regulation and decision-making and reduces the volume of the area responsible for anxiety, stress and fear.
Experiential Therapies Promote Healing
Experiential treatments are fun, engaging and enlightening. Making them a part of your recovery journey will enhance healing and promote a greater sense of well-being during treatment and beyond.
- SAMHSA’s Working Definition of Recovery
- Experiential Learning Experience As The Source of Learning and Development
- The Connection Between Art, Healing and Public Health: A Review of Current Literature
- The Use of Art and Music Therapy in Substance Abuse Treatment Programs
- Horticulture: A Therapeutic Tool
- Reining in PTSD with Equestrian Therapy
- Neurofeedback Training for Opiate Addiction: Improvement of Mental Health and Craving
- Effects of a therapeutic camping program on addiction recovery. The Algonquin Haymarket Relapse Prevention Program
- Complementary Therapy for Addiction: “Drumming Out Drugs”
- Yoga as a practice tool
- Mindfulness-Based Therapies for Substance Use Disorders: Part 1 (Editorial)