Psychotherapy - Disorders of Sedative–Hypnotics

Psychotherapy

The self-medication model, even if accurate in a particular case, is not a good one because once drug abuse or dependence becomes established the drug use takes on a life of its own regardless of the underlying reason for initiation. Rarely is treatment with insight-oriented psychotherapy successful in stopping the drug use. During early recovery, most patients are coping with subtle withdrawal symptoms, repairing relationships and learning to function without reliance on psychoactive drugs. Patients with underlying psychiatric disorders may have the additional bur-den of emergence of symptoms that had been ameliorated by their drug use. Psychotherapy during early recovery should be supportive and focused on coping with current life difficulties. Psychotherapists should remain vigilant for symptoms of panicattacks, generalized anxiety, depression, or sleep disturbances that interfere with current function and should initiate appropriate psychopharmacological or somatic treatments when appropriate.

Psychotherapy can, however, have an important role in motivating a patient for primary treatment of drug dependency. Therapists can help break down patients’ denial of their drug de-pendence by helping them see how drug use is interfering with relationships and undermining their ability to function. In some instances, it is desirable to continue the psychotherapeutic rela-tionship while the patient is undergoing treatment for chemical dependence. With drug abusers, it is often desirable to separate the medication management from psychotherapy to prevent the psychotherapy from becoming bogged down in discussions of medications and medication side effects.