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Treatment Modalities

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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 page introduces the modalities used across The Archangel Centers and links to the guides where each is covered in depth.

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

Medication-Assisted Treatment: What Archangel Prescribes

What is in the clinical toolkit?

ModalityWhat it isOften used for
Cognitive behavioral therapy (CBT)Identifying and changing thoughts and behaviors that drive useAlmost universal in SUD treatment
Dialectical behavior therapy (DBT)Distress tolerance, emotion regulation, interpersonal skillsCo-occurring mood/personality disorders, self-harm, impulsivity
Group therapyStructured peer-based process and skill groupsCore modality across all levels of care
Family therapyThe family system as a unit of treatmentAll SUD presentations
Medication-assisted treatment (MAT)Medications that reduce craving, prevent return to useOpioid use disorder, alcohol use disorder
Trauma-informed careTreating trauma alongside addictionCo-occurring PTSD, complex trauma
Motivational interviewing (MI)Resolving ambivalence about changeEarly treatment, treatment-resistant clients
Relapse preventionIdentifying triggers and building coping plansUniversal across the continuum

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, 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
8 Evidence-Based Therapies at Archangel

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.

Which modalities does Archangel use less commonly?

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:

How Therapy Is Delivered Across Levels of Care

Frequently Asked Questions

Do I need all of these therapies?

The treatment plan is individualized. Most clients engage with several modalities; few need every one.

What if a modality doesn't work for me?

Clinical work is iterative. If a modality is not producing change after a fair trial, the team revises the plan. The relationship continues; the technique adjusts.

Are these modalities offered virtually?

Most are. Virtual delivery at The Archangel Centers is currently structured for New Jersey residents. Charlotte-area clients receive treatment in person.

Who decides which modalities I will use?

The treatment team, in collaboration with you. The intake assessment generates initial recommendations; the assigned primary therapist refines the plan over time.

Am I a candidate for medication-assisted treatment?

MAT is most commonly indicated for opioid use disorder and alcohol use disorder, and the decision is made by the medical provider after evaluating substance, severity, prior treatment, and co-occurring conditions. The Archangel Centers' formulary is Suboxone (buprenorphine/naloxone), Vivitrol (naltrexone), and Sublocade; methadone is not in our formulary, and clients who need methadone are referred to a federally licensed opioid treatment program. Declining MAT does not disqualify you from any level of care.

How do group and individual therapy work together?

Group therapy is the primary modality across PHP and IOP because most of the clinical change in addiction treatment happens in peer-based process and skill work. Individual therapy runs in parallel, weekly in Partial Care and IOP, with your assigned primary therapist. Group addresses what is generalizable; individual addresses what is private, complicated, or trauma-linked.

How are co-occurring mental health conditions treated alongside addiction?

Co-occurring depression, anxiety, trauma, and other conditions are treated alongside addiction, not after it. Every client receives ASAM and LOCUS assessments at intake plus PHQ-9, GAD-7, and Columbia suicide screening, and the treatment plan integrates SUD work with mental health work in the same groups and the same individual sessions. Psychiatric medication is managed by the on-staff medical provider.

Which modalities continue after I step down to OP?

Individual therapy with your primary therapist continues, MAT continues under the same medical provider, and periodic continuing-care groups (relapse prevention, alumni, dual diagnosis) remain available. The clinical relationship is the constant; what changes is frequency. Most clients keep the same therapist across Partial Care, IOP, and OP at The Archangel Centers.