Treatment Modalities

The therapies used in evidence-based addiction treatment are not a grab bag. Each has a research base, specific situations where it is the right tool, and ways it combines with the others to do real clinical work. This pillar page introduces the modalities used across The Archangel Centers and links to the leaf pages where each is covered in depth.

For the broader picture of how levels of care use these modalities, see the levels of care cluster. For the substance-specific application, see the substances cluster.

The toolkit at a glance

How modalities combine

In practice, no single modality is sufficient. A typical treatment plan combines:

• A primary therapy framework (often CBT, sometimes DBT for clients whose dysregulation is severe)
• Medication-assisted treatment when clinically indicated, for opioid and alcohol use disorders
• Trauma-informed care as the default across groups and individual sessions, with EMDR available for clients whose individual therapist recommends it
• Group therapy for peer-based process and skill work
• Family therapy in parallel with primary treatment
• Relapse prevention woven through the entire continuum
• Motivational interviewing in the way the clinician engages, regardless of the modality used in the room

What "evidence-based" actually means

In addiction medicine, evidence-based means the therapy has been studied in controlled trials, with replicable outcomes, against active comparison conditions. The modalities listed above all meet that bar to varying degrees, with the strongest evidence for MAT (for opioid and alcohol use disorders), CBT, contingency management (for stimulant use disorders), and motivational interviewing.

"Evidence-based" does not mean the only thing that ever helps. It means the things that have been shown to help on average, in studies, well enough that we can recommend them with confidence. Individual treatment plans are tailored to the person.

Modalities we use less commonly, or not at all

A few things worth being explicit about:

This list is not a critique of every alternative approach. It is a description of what we do and what we do not, so people considering treatment can make informed decisions.

• Equine therapy, art therapy, music therapy. Useful for some clients, less central to the clinical evidence base. We do not feature them in our core program.
• Wilderness or adventure therapy. Not part of our outpatient model.
• Unproven or experimental therapies. We do not offer ibogaine, ayahuasca, or other psychedelic-assisted therapies; the evidence base is emerging but not yet at the threshold for an FDA-approved indication for SUD outside specific research settings.
• "Brain rebalancing" or NAD+ infusions. We do not offer these. The clinical evidence base does not support them as standalone or primary treatments for SUD.
• Methadone. Not in our formulary; clients who need methadone are referred to a federally licensed opioid treatment program.

How modalities map to our levels of care

The modalities above are delivered across our outpatient continuum:

• **Partial Care at Tinton Falls and PHP at Charlotte**: All modalities, daily, in a structured full clinical day
• **IOP at Tinton Falls and IOP at Charlotte**: All modalities, three or five days a week, three clinical hours per session
• **OP at Tinton Falls and OP at Charlotte**: Individual therapy, periodic group work, and MAT continuation