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Addiction Treatment Modalities: Which Ones Really Work?

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addiction treatment modalitiesIf you’re seeking treatment for an addiction, you probably already know that there’s a lot of spin involved in the rehab industry.

The number of different addiction treatment modalities has increased dramatically. It can be difficult to discern the differences and distinguish the programs that are worth your time and money.

Second in a series. See the first post as well - Treatment Modalities, Part 1: What Are My Options?


Knowing what to look for can make all the difference. In this post, we’ll outline the various types of addiction treatment modalities and their success rates. We’ll explore relevant research and share our analysis of the data too. So if you want a clearer path forward into recovery, read on.

Treatment Modality Definition

Treatment modality is simply the method used to treat a patient for a particular condition. In everyday language, you may also hear both patients and medical professionals use "approach" or "type" and other such descriptions.

Substance Abuse Treatment Modalities

Broadly speaking, addiction treatment modalities can be categorized along the following lines:

  • Medical
    • Medication-assisted detox programs and mood-altering drugs
  • Psychological
    • Behavioral techniques from aversion therapy to family therapy
  • Sociocultural
    • Inpatient treatment programs as well as 12 Steps groups
This is based on research in The Effectiveness and Costs of Alcoholism Treatment

Plenty of addiction recovery centers claim to be effective, but which approaches really work? How do you know what methods are worth your time, effort, and investment and which ones are not?

We understand the struggle, and that’s why we’ve done the homework for you. We know how challenging it can be to try and sort through tons of different treatment possibilities, so consider this as a way to narrow your options.

Which Addiction Treatment Modalities Actually Work?

Though there are a wide variety of different treatment modalities for substance abuse available, not all of them are equally effective.

In Chapter Two of The Handbook of Alcoholism Treatment Approaches, authors Reid Hester and William Miller list 48 different types of addiction treatment modalities, along with their degree of effectiveness within the context of clinical trials.

These 48 approaches can be grouped into six overarching treatment modalities, as listed in the first column of the table below (Aversion Therapy, Holistic Treatment, Behavior Modification Only, Medication Only, 12 Step Related Treatment, and Education).

The second column contains the average rank of each modality, so that you can see how they stand up to scrutiny. The lower the average rank score, the better for the treatment modality.

Note: it’s important to remember that categories such as Holistic Treatment were hampered by the inclusion of several ineffective treatment approaches such as hypnosis.

In the third column, we’ve included one or two sample addiction therapies which are representative of the modality as a whole.

Addiction Treatment Modality

Average Rank of Treatment Modality
(lower = more effective)

Examples of Modality as a Whole

The Clearing (evidence-based holistic / spiritual)

10 (est)

  • Evidence-based techniques
  • Underlying core issues
  • Dual diagnosis treatment
  • Professional counseling

Aversion Therapy
 - Includes nausea, electroshock


  • Nausea
  • Covert Sensitization

Holistic Treatment


  • Evidence-based psychological treatment modalities
  • Professional counseling
  • Exercise
  • Acupuncture

Behavior Modification Only
- Includes behavioral-focused therapy and groups


  • Brief Interventions
  • Behavior Contracting
  • Relaxation Training

Medication Only
 - Includes detox drugs


  • Antidepressants
  • Anti-Anxiety Drugs
  • Naltrexone
  • Antabuse

12 Steps Related Treatment
 - Includes AA & similar groups


Alcoholics Anonymous

Education Only
 - includes books and video lessons


  • Tapes
  • Lectures
  • Films

Interpreting the Addiction Treatment Modality Summary Table

Aversion Therapy received the best average rank, because it can work well when an addiction is purely physical in nature.

However, Aversion Therapy provides only a short-term benefit when there are underlying emotional issues involved in the addiction. Often an individual will switch addictions when the root cause is not addressed.

Employing proven behavior modification techniques is also effective. However, there is a caveat: in order to effect lasting change, these techniques must be used after an individual has dealt with their underlying core issues, not before.

With that in mind, some of the most effective behavioral modification approaches include brief interventions and Motivational Enhancement Therapy (MET).

  • Brief interventions are short, one-on-one counseling sessions with a trained professional counselor, which typically include both personalized feedback and motivational interviewing techniques.
  • Motivational enhancement therapy is a type of counseling that promotes internally-driven behavioral change.

Holistic therapies promote healing on physical, mental, and emotional levels simultaneously. Truly holistic addiction treatment involves a combination of powerful, integrative modalities.

For example, a holistic treatment center might use evidence-based psychological approaches such as Person Centered Therapy, Rational Emotive Therapy, and Gestalt; when these techniques are coupled with meditation, body work (such as massage), and exercise, they comprise a true holistic approach.

The average score for holistic therapies is lower than Aversion Therapy and Behavior Modification Therapy because the umbrella term “Holistic Therapy” includes a wide range of addiction treatment modalities, and many of them have not proven to be effective.

In the list of 48 substance abuse treatment modalities provided in The Handbook of Alcoholism Treatment Approaches, holistic therapy encompasses proven approaches such as those outlined above as well as more unreliable practices such as hypnosis.

Finally, 12 Steps Related Treatment and Education Only landed at the bottom of the list in terms of average rank for effectiveness.

Which treatment modality will work for me?

Now that you’ve learned about the different treatment modalities available, it’s time to discern which one is a good fit for you. You’ll want to take a hard look at the severity of your addiction, your level of commitment to healing, and your beliefs surrounding growth and change.

05wellBrody-articleInline.jpgAs Jane E. Brody writes in her New York Times article, Effective Addiction Treatment, “If a 12-step program like AA is not right for you, don’t choose it just because it’s the best known approach.”

Brody also quotes medical writer Anne M. Fletcher, who counsels potential rehab participants to meet with treatment teams and ask about the specific services offered.

Fletcher emphasizes the importance of personalized professional counseling in addiction recovery: “‘[Treatment] should be more than movies, lectures or three-hour classes …. You should be treated by a licensed addiction counselor who will see you one-on-one. Treatment should be individualized. One size does not fit all.’”

One-on-one professional addiction counseling is essential for individuals with a dual diagnosis, a substance addiction combined with a mental health condition such as anxiety or depression. Most people dealing with addiction have a dual diagnosis.

If you have a mental health condition along with an addiction, your recovery hinges on your willingness to address and heal the underlying mental and emotional issues that are driving your substance abuse.

Look for an addiction recovery program that …

  • Treats your addiction and mental health concern simulaneously and holistically
  • Effectively addresses the underlying core issues that drive addiction
  • Educates participants about the addictive cycle and how to break free from it
  • Offers concrete professional supports

If you’re looking for residential treatment on the Pacific Coast, take a look at our posts comparing Dual Diagnosis Treatment Centers in Washington State (WA) and Dual Diagnosis Treatment Centers in California (CA); we’ve done the research for you!

Learn more about our approach to Treatment by downloading our Free eBook: Healing Underlying Core Issues:

Download eBook:

Healing Underlying Core Issues


Caroline McGraw

This post was written by Caroline McGraw

In addition to her work as "the voice of The Clearing", Caroline Garnet McGraw writes about trading perfectionism for possibility at A Wish Come Clear. Visit and receive your free Perfectionist Recovery Toolkit today!

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