There is a lot of diversity in the approaches used to treat substance abuse. A very common approach is based on the psychomedical paradigm of counseling. These programs are generally loosely based on what is known as the "Minnessota model" which is named after the American state where pioneering work was performed. Other models stem from religious paradigms or behaviour modification paradigms.

 A program based on the psychomedical approach will incorporate elements based on addressing the individual. Therapeutic techniques such as one-to-one counseling and group psychotherapy will be used in conjunction with other components such as psychiatric medication, occupational therapy (such as art, yoga, or drama). Many programs will encourage their participants to develop on their spiritual understanding, without neccessarily prescribing to any single religious doctrine. The psychomedical fraternity values scientific knowledge and operates from a paradigm of offering expert advice to their clients. The "Disease Model" of addiction is commonly accepted by clinics operating under this paradigm.

Religious programs usually include a large amount of encouragement for clients to develop their spiritual relationship with the aim to obtaining a Divine cure. Many of these programs will include program elements such as counseling that are also found in the psychomedical approach. The only drawback to such a program is that they often do not allow their clients to choose a religion and prescribe their own religious views upon the client.

The 12 step fellowships offer a program but make no claim to offer professional services of any sort. South African facilities usually suggest that continued attendance at these fellowships is an effective way to maintain ongoing recovery and growth. Religious programs typically do not encourage 12 step attendance and generally prefer their clients to attend church and become involved in their own support structures.

Treatment can be offered 'in patient' or 'out patient'. Inpatient treatment is also known as 'residential' treatment. There are specific advantages to this form of treatment, not least of which is that it is relatively more difficult to relapse in those first crucial weeks if the client is in a clinic. Outpatient treatment is usually less expensive and is offered to clients who are logistically incapable of attending residential treatment. Once a client has completed inpatient treatment he/she may be invited to attend ongoing outpatient therapy.

In the psychomedical approach a treatment team will usually consist of a number of professionals (psychiatrists, psychologists, medical doctors, nurses) and paraprofessionals (addictions counselors and other lay counselors). A treatment approach will typically involve this team working together to develop a rich understanding of the addicts problem.

Treatment is usually offered in tiers or phases, which we will explore in later posts.