Many -or most- addiction treatments don´t really work in the long run. According to my observations, this is due to the therapist´s lack of understanding where the client´s keys got lost. You can intensely look all over the place for a loooooong period of time- if you are not looking where it really got lost, then it seems hardly feasible that the afflicted-addicted human will find it there. Maybe something, but not it. The golden questions is: what is it ?
BTW and for instant clarification´s sake: I am not saying that the treatment of addictions solely is the responsibility of the therapist. The human-being-turned-addict´s life and choices are
100 % his/her own. Which BTW doesn´t mean that the therapist is without responsibility: (S)He is equally 100 % responsible- for her/his work. But NOT for the life and karma of the Other. Which means, BTW, that the totalt effect of the therapeutic process might well be ....a 50/50 equation.
Many therapies -even though their apparal seems more sophicated on in our days of perfected external shells- still implicitly are based on the «get a grip on your self, (wo-) man» premise. Simply asking an addict to flex their will muscles and abstain would about as promising of a prospect as leaving a 7 year old alone at home with a bottle of Cola, a bowl of chips and a KungFu movie blaring on the TV, saying: «dude, be good, eat your muesli and do your homework».
The quintessential question to start the descend (in order to ascend later with the keys) with, would have to be: « which psychological hole is the addict symbolically trying to fill with the addiction and its implications? « It´s crucial to underline symbolically in this context as the chain of misunderstandings already heads off into the wrong direction when the abuse and its consequences are taken too literally. As if what you see, is what it is. Nope. Such a judgement couldn´t be farther off the mark.
In a truer reality than reality, the addict is on a unconscious mission, a quest for something that he has lost or feels never had. The addiction is attempt to create an Ersatz, a replacement, for that which has been lost or not yet attained. But- (s)he does not know that. And as long as the therapist doesn´t really know that (or what) either, Noah´s Arc may have a hard time reaching dry land in the neaer-or any-future.
Any therapeutic intervention will in the first instance have to take the Black Hole in the patient´s psyche into consideration.
After finding what was ripped out of the Whole, or not yet found, the therapeutic process will have to find means that symbolically fit and thus fill that blank. Then the Black Hole can grow to become a Black Whole. And eventually turn into a White Whole, because there is no need for Black, the no-colour, anymore. And not even a hole anymore.