The Matrix Model: Alcoholism Treatment That Isn’t One-Size-Fits-All

In the 1980s, America experienced a cocaine epidemic. At the time, there were no specific treatment programs for treatment of stimulant use disorders. 1 The primary addiction support and treatment programs in existence were Alcoholics Anonymous for those with alcohol use disorder and methadone clinics for those with opioid use disorder.

The Matrix model was developed to address the needs of individuals with stimulant use disorder who required more intensive care than the outpatient options available at the time.1 Because the Matrix model is intended to provide comprehensive care, the approach has since been adapted to address the needs of individuals with any type of addiction, including alcohol use disorder.1

In this article:

The Matrix Model for Addiction Treatment

The Matrix model is an intensive outpatient program (IOP). It is considered a structured, intensive program that offers education focused on improving your life, coping, relapse prevention, and social skills. This approach does so through combining multiple evidence-based, multi-layered programs. Each component of the model is designed to give you support throughout the week on an outpatient basis.1

For at least 16 weeks, you receive multiple forms of treatment that support recovery from addiction. Treatments include group and individual therapies, family therapy, and medication management when medically indicated.1

Components of the Matrix Model

When you begin, you are given the Matrix model substance abuse manual. The manual includes tools and techniques intended to facilitate a well-rounded recovery program. Because many risk factors and contributing elements lead to addiction, many individuals find that they need specific supports to address multiple factors in their addition. The Matrix model incorporates the following treatment modalities.1,3

Individual Therapy

Meeting one-on-one with a therapist allows you to discuss the work you are doing in groups, assess your progress, and evaluate when to adjust your schedule based on your current needs. 1 In most programs, you will meet at least weekly with your therapist, as well as several times throughout the program for formal assessments.3 When you are close to finishing the program, you and your therapist will work on an aftercare plan together.1,3

Family Education Therapy

Family education meetings are one of the characterizing modalities of the Matrix model and one of the components that can offer lasting benefits.1 These groups are a type of educational groups where your family members learn more about addiction, enabling behaviors, boundaries, triggers, effects of addiction on the brain, and how they can help you stay in recovery.3

Family involvement in the Matrix model is a way of healing the whole family, so you can regain your family support network and you can work together with your loved ones to repair interpersonal relationships.1,3

12-Step Programs

Programs like Alcoholics Anonymous (AA) and Narcotics Anonymous (NA), which are the oldest 12-step programs, are still used to help individuals achieve and maintain recovery. 1 Newer 12-step programs are also used. Twelve-step programs are a type of peer support rather than group therapy. While both group meetings include individuals working toward the goal of recovery, peer support groups focus on gaining the specific insight of hearing the struggles and successes of your peers on their recovery journeys.3

In 12-step meetings, the meeting may focus on one step each week or each person may speak to the step they are currently working on. You get to offer feedback and encouragement to someone struggling in their recovery. You may also have the opportunity to listen to experts speak on 12-step works and addiction recovery in speaker-style meetings.3

Addiction Education Group

When you attend an addiction education session, you can expect to learn about addiction as a medical condition, including the physiology and psychology of substance use disorders. 1 Topics that may be covered include why misuse of substances like alcohol lead to addiction, the physical and psychological aspects that contribute to the development of addiction, and how to retrain your brain to aid in recovery.1

Early Recovery Skills Group

Early recovery skills groups are led by licensed addiction specialists who provide information on different ways to prevent relapse. 3 You can practice these skills when you are away from the program in your daily life. Skills include time management, cognitive tools to reduce cravings, and connecting with community resources.1

Substance Testing

Urine analysis testing happens randomly in most Matrix model programs to help you become accountable for your substance use while you are not actively attending program activities. In a Matrix model program for alcohol use disorder, you may also be given random breath-alcohol testing if you appear intoxicated during a group. 2 This measure is not punitive, but is intended as a tool to help you achieve sobriety initially and maintain it sustainably. If you test positive for substances, your therapist may suggest increasing services until you are able to maintain sobriety with fewer supports.2

Relapse Prevention Groups

Relapse prevention groups are facilitated by a licensed professional but can be co-led with someone later in recovery. 2 Groups will take place for the entirety of the program. They offer a time to give and get feedback from peers and follow a workbook format teaching methods of preventing relapse.3

You will likely cover anger management, stress management, interpersonal communication, sex and recovery, spirituality, repairing relationships, and finding and maintaining motivation for recovery. 2 This is not a comprehensive list of topics covered by all Matrix model relapse prevention groups, your program may cover numerous other topics. The goal of relapse prevention groups is to help you change your thought patterns and learn coping skills so that you can avoid relapse in potentially triggering situations.2

Social Support Groups

Social support groups are run by a counselor and alumni of the Matrix Model addiction program. Co-leading allows alumni to give back and be accountable. 2 They help you by allowing you to see that recovery success is possible. 3

Treatment Modalities in the Matrix Model

Individual and group therapy sessions in the Matrix model of addiction treatment use evidence-based therapies. For example, cognitive behavioral therapy (CBT) is used to facilitate behavioral changes, identify triggers, understand psychopharmacology, learn coping skills, and identify triggers.3,4

Contingency management involves receiving a previously specified reward when you reach a goal. Other treatment modalities include motivational enhancement, family therapy, and 12-step facilitation.3

Your IOP schedule of programs will be based on an extensive assessment, with your Matrix model plan depending on your needs, medical status, and current living situation (e.g., housing, relationship with nearby family members, etc.). Your Matrix model plan will break down each day of the week for 16 weeks or more.3

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Typical Schedule for a Matrix Model Program

In most Matrix model plans, you will follow one schedule for the first four weeks before transitioning out of an early recovery-focused plan and into a plan designed to help you maintain sobriety after the program at week five. 3

Weeks 1-4

Think of learning new skills as a protective coating. Each new skill you learn can help protect you from a potential relapse. If you have fewer skills available, relapse may be more likely to happen. If you have established an expansive toolbox of skills—or metaphorical layers of protection—you may have a lower risk of relapse, even in triggering situations.

An example weekly schedule in the first month of Matrix model addiction program may look like the following:3

  • Monday: relapse prevention group and early recovery skills group
  • Tuesday: individual counseling and 12-step group
  • Wednesday: relapse prevention group and early recovery skills group
  • Thursday: family therapy and 12-step group
  • Friday: relapse prevention group and early recovery skills group
  • Weekend: social support groups and recovery activities

Relapse prevention and early recovery groups are often offered three times a week during the first phase of the Matrix model schedule because you are more vulnerable to relapse during this time.

The first phase of the Matrix Model also includes family therapy and education, individual counseling, 12-step groups, social support groups, and recovery activities. Your family may have been affected by your alcohol use disorder, so it is recommended that they be part of your recovery process if possible.

Twelve-step and social support groups allow you to garner support for recovery from resources in the community. After you complete the Matrix model, these supports will be in place if you need them.

The recovery activities you may be involved in on the weekend are the activities you do outside of treatment with your program group, program facilitators, family members, or alone. You may plan activities you do alone or with family members ahead of time with your therapist. Exploring new activities can help you find sober alternatives you enjoy and can continue after treatment to replace substance use behaviors. Recovery activities may include going to the movies, preparing to participate in an athletic event such as a 5k or marathon, attending a religious service, visiting a natural place like an botanical or butterfly garden, visiting sober family members, taking a class to learn a new skill, and volunteering in your community.

Weeks 5-16

During the second phase of your Matrix model plan, you will likely feel a level of stability in your sobriety. The services you receive in this phase continue to create those protective layers against potential relapse as well as to help you look ahead toward stepping down in care level.

An example weekly schedule after the first month of Matrix model addiction program may look like the following:3

  • Monday: relapse prevention group
  • Tuesday: 12-step group
  • Wednesday: relapse prevention group
  • Thursday: family therapy
  • Friday: relapse prevention group
  • Weekend: social support groups or recovery activities

During the second phase of Matrix model treatment, you will likely spend fewer hours in treatment. Your plan will focus on building on the skills you have already learned, continuing to improve the relationships in your life, and establishing the supports you will need after the program ends. For example, the 12-step group you attend may be one that you can continue going to during the aftercare phase of your treatment plan.

You will likely only see your individual therapist for planned assessments of your goals and progress during this phase.

Readiness for Matrix Model Addiction Treatment

You will find the Matrix Model of addiction treatment may be recommended for you if:5

  • You are no longer using drugs or alcohol but need education and support in your recovery
  • You can participate fully in group therapies
  • You have been in individual outpatient counseling but need more support
  • You are stepping down from an inpatient setting and need continued care
  • You need intensive treatment but inpatient treatment is not accessible due to cost or other barriers
  • You have work or home obligations that will not allow you to attend inpatient rehab
  • You are involved with the criminal justice system and have court-mandated substance misuse treatment
  • You need treatment for both a substance use disorder and a mental health condition
  • You need medication to help you maintain sobriety from alcohol or drugs
  • You need medication to help you overcome mental health symptoms
  • You are motivated for change

The Matrix model helps you build relationships with local support services, learn the necessary tools for maintaining sobriety, and stay accountable on a flexible schedule. This treatment approach gives you the intense structure of the programs you may receive in an inpatient treatment facility while allowing you to remain connected to your home life.5

If you think the Matrix model addiction treatment could be the right solution for your recovery or want to know more about IOP for addiction treatment call 800-948-8417 Info iconCalls are forwarded to paid advertisers . We have treatment specialists available 24/7 to answer questions and get you started on your recovery journey.

Resources

  1. Substance Abuse and Mental Health Services Administration. (2006). Substance Abuse: Clinical Issues in Intensive Outpatient Treatment – Chapter 8: Intensive Outpatient Treatment Approaches. Center for Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series, No. 47.
  2. Substance Abuse and Mental Health Services Administration. (2014). Counselor’s Treatment Manual. Matrix Intensive Outpatient Treatment for People with Stimulant Use Disorders.
  3. Center for Substance Abuse Treatment. (2006). Substance Abuse: Clinical Issues in Intensive Outpatient Treatment – Chapter 4: Services in Intensive Outpatient Programs. Rockville (MD): Substance Abuse and Mental Health Services Administration (US). Treatment Improvement Protocol (TIP) Series, No. 47.
  4. Subtance Abuse and Mental Health Services Administration (2006). Substance Abuse: Clinical Issues in Intensive Outpatient Treatment – Chapter 2: Principles of Intensive Outpatient Treatment. Center for Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series, No. 47.
  5. Substance Abuse and Mental Health Services Administration. (2017). Client’s Handbook. Matrix Intensive Outpatient Treatment for People With Stimulant Use Disorders.
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