Addiction Therapy

Overview Of Addiction Therapy

Many see addiction recovery as mainly focusing on quitting alcohol or drug use. While that’s true, receiving therapy or counseling is just as vital to success.

The National Institute on Drug Abuse recommends that providers of substance use disorder treatment include behavioral therapy in every recovering addict’s treatment plan.

Common categories of addiction therapy include:

• Individual Therapy
• Group Therapy
• Family Therapy
• Couples Therapy

Therapy helps recovering addicts identify triggers and work through emotional issues that may have led to addictive behavior. It also supports relapse prevention by providing patients with healthier coping skills and better self-esteem.

Individual Therapy

Individual therapy or individual counseling is what most people think of when discussing therapy. Generally, it involves the patient and a licensed therapist in a private, comfortable room where they can speak freely and without judgment.

When patients undergo individual drug or alcohol addiction therapy, the licensed therapist will typically spend the first session learning the patient’s general history. During session one, the therapist will usually ask about diagnosed mental health conditions, family medical history, past traumas, co-occurring health conditions, and/or history of addiction.

Then, the therapist will use this history to help the patient determine the sources and/or causes of the addictive behavior.

The ultimate goal is to develop a short-term and long-term strategy to avoid addictive behaviors in the future, often finding replacement activities to engage in when cravings or temptations occur.

Group Therapy

As the name suggests, group therapy occurs in a group setting with other patients struggling with addiction. A licensed counselor usually conducts the session, and attendees are encouraged to share their stories and support one another.

Group therapy can be especially powerful for those who feel intimidated by a one-on-one session or want to meet others with similar struggles.

Counselors will ask each patient to introduce themselves to the group and engage in activities to break the ice, share their experiences, and ultimately feel a sense of unity with others in a safe, supportive environment.

Family Therapy

Addiction often negatively impacts family members, leading to resentment and uncertainty. When a family is at odds, unproductive arguments can break out.

But when a counselor participates in the conversation, they can provide an objective perspective and ensure each person has a chance to express themselves.

Calm, compassionate discussion can help the person with an addiction and their family members better understand each other’s pain so they can find a path forward.

Family therapy aims to create a comfortable setting for all parties, allowing their concerns to be heard and developing a strategy to help the addict feel supported and held accountable.

Couples Therapy

When someone struggles with addiction, their partner often gets caught in the crossfire. Just as family therapy can create an environment where all parties can be acknowledged and heard, couples therapy can provide the same benefits.

Working with a licensed counselor can ensure that discussions with your partner are productive and help both parties find an achievable and sustainable treatment strategy. Couples therapy can also help strengthen your relationship and/or marriage.

Psychotherapy for Addiction Treatment

Psychotherapy focuses on long-term treatment, and psychotherapists generally require more training. Psychotherapy aims to address the root cause of the patient’s issues, diving deeper than a general counseling session.

A key difference between psychotherapists and counselors is that psychotherapists can provide counseling, but not all counselors have the training to provide psychotherapy.

Psychotherapy can be highly effective in treating addiction because, generally speaking, addiction is often rooted deeply in the addict’s behavior and requires intensive strategies to address it.

The types of psychotherapy can be varied, but the most common types include:

• Cognitive Behavioral Therapy (CBT)
• Dialectical Behavioral Therapy (DBT)
• Rational Emotive Behavior Therapy (REBT)
• Motivational Interviewing
• Eye Movement Desensitization and Reprocessing (EMDR)

Cognitive Behavioral Therapy (CBT)

When people think of therapy in general, they often picture Cognitive Behavioral Therapy (CBT). CBT is the more common treatment prescribed to those suffering from mental illnesses and addiction. CBT is conducted one-on-one with a licensed mental health care provider and can occur weekly, biweekly, or monthly.

The ultimate aim of CBT is for the patient to become more aware of negative thought patterns. Patients then learn how to view and respond more effectively to challenging situations to avoid self-destructive behavior in the future.

CBT can assist with:

• Managing and redirecting cravings
• Preventing relapse
• Learning coping techniques for stressful life situations
• Identifying ways to manage intense emotions
• Resolving relationship conflicts
• Learning better ways to communicate

Dialectical Behavioral Therapy (DBT)

While CBT focuses on being aware of your thought patterns and behavior, Dialectical Behavioral Therapy (DBT) is a cognitive therapy more targeted at balancing intense emotions and avoiding conflict in relationships.

Originally developed to treat Borderline Personality Disorder, DBT has also proven effective for addiction and substance use disorder. However, DBT shines in its ability to help patients find balance and avoid black-and-white or all-or-nothing thinking.

DBT can assist with:

• Improving the ability to regulate emotions
• Tolerating distress and negative emotions
• Finding balance in opposite perspectives instead of black-and-white thinking
• Communicating effectively with others
• Feeling more present and less lost in emotions

Rational Emotive Behavior Therapy (REBT)

Rational Emotive Behavior Therapy (REBT) is a method that focuses on self-defeating thoughts and feelings by challenging the rationality of those feelings. REBT can be very effective for patients who are more responsive to rational or analytical processes.

The strategy with REBT is to identify these self-defeating thoughts and feelings, challenge their validity, and replace them with healthier, more productive beliefs.

Where CBT focuses on how thought patterns affect behavior, and DBT focuses on balancing intense, oppositional emotions, REBT challenges patients’ beliefs about themselves.

REBT can assist with:

• Identifying and replacing self-defeating, negative beliefs and feelings
• Avoiding self-destructive and irrational behaviors
• Improving self-esteem and self-regard
• Letting go of negative thoughts
• Learning to accept yourself and others

Motivational Interviewing

Some recovering addicts find themselves struggling with motivation and may need some guidance to prepare for this significant lifestyle change. Motivational Interviewing is a short-term therapy that usually lasts 1-2 sessions.

The therapist will interview the patient about their current state of mind and help them work through their resistance toward the changes they ultimately want to make.

Motivational Interviewing can assist with:

• Moving past feelings of resistance toward sobriety
• Identifying one’s inherent motivations
• Working through feelings of resentment or anger
• Instilling self-confidence
• Discovering discrepancies between goals and current behavior

Eye Movement Desensitization and Reprocessing (EMDR)

Developed to address trauma in those with Post-Traumatic Stress Disorder (PTSD), Eye Movement Desensitization and Reprocessing (EMDR) has been very effective for substance use disorder.

EMDR is a psychotherapy that enables the patient to heal from the emotional distress and symptoms experienced due to a disturbing life experience or trauma.

The medical community has established a link between addiction and trauma, as many often self-medicate to cope with trauma or experience trauma resulting from substance abuse. According to the National Institutes of Mental Health, up to 59% of young people with PTSD develop substance abuse problems.

EMDR works by desensitizing the patient to triggers and allowing the mind to heal from unprocessed trauma memories. There are eight phases in the treatment process, and a licensed therapist guides the patient through the process.

EMDR can help those struggling with addiction heal from trauma and avoid relapse in the future. In addition, as EMDR desensitizes patients to triggers, many people find they can more easily combat temptation should they encounter a trigger.

Other Types of Therapy for Treating Addiction

Aside from the three psychotherapy approaches previously discussed, a few other techniques have proved effective for addiction. These methods can be combined with many different options as a supplement or used on their own to treat substance and alcohol use disorder.

Contingency Management

Contingency management (CM) uses the power of tangible rewards to encourage and reinforce positive behaviors, making these methods a great supplement to psychotherapy.

Contingency management features two leading practices: Voucher-Based Reinforcement (VBR) and Prize Incentives Contingency Management.

Voucher-Based Reinforcement (VBR)

Voucher-based reinforcement (VBR) often works well for people with an addiction struggling with opioid or stimulant abuse (such as cocaine or methamphetamine). VBR works by awarding the patient a voucher for every drug-free sample provided. Patients can exchange vouchers for food, movie tickets, or other goods and services consistent with a substance-free lifestyle.

These vouchers are initially low in value, only increasing when drug-free samples increase. If a sample returns positive for substances, the voucher value is reset to the lowest value, encouraging the patient to continue abstaining to maintain higher-value vouchers.

Prize Incentives Contingency Management

Prize Incentives Contingency Management operates similarly, using cash prizes instead of vouchers. During Prize Incentives Contingency Management, patients with drug-free samples can draw from a bowl to win prizes worth between $1 and $100.

Patients can also earn drawings by completing other tasks like attending therapy sessions and meeting specific goals. The number of times a patient can draw begins at one and will increase with each consecutive negative drug test. Should a patient test positive, the number of draws will reset to one.

Complementary Addiction Treatment Options

Addiction treatment exists at both an inpatient and an outpatient level, with varying intensity levels depending on the patient’s individual needs.

Medical Detox

In many cases, detoxification is one of the first steps of the addiction recovery process. When the body detoxes, it rids itself of the substance it had gotten used to (i.e., developed dependency).

Individuals should seek medical intervention and guidance when quitting any substance, as some withdrawal symptoms can be life-threatening.

Some rehab centers offer in-house medical detox services, while others will refer patients to a detox center. In many cases, patients can undergo medical detox safely at home but with the guidance of a doctor or addiction counselor.

Rehab Programs

Generally speaking, there are two main types of addiction rehab programs: inpatient rehab and outpatient rehab.

Inpatient and outpatient treatment facilities provide different therapy options—most commonly a combination of individual and group therapy sessions—as part of their substance abuse treatment program.

Medication-Assisted Treatment

Sometimes, your doctor or addiction treatment specialist will also prescribe specific medications to support you along with your therapy treatment. These types of medications can help alleviate withdrawal symptoms and prevent relapse so you can better focus on your therapy and overall recovery.

These prescription medications may include:

• Buprenorphine
• Methadone
• Naltrexone

12-Step Programs

Due to its popularity, many people have heard of 12-step programs before. Standard 12-step programs include Alcoholics Anonymous (AA) and Narcotics Anonymous (NA).

These self-help groups can be very effective but are notably NOT considered addiction therapy.

Alcoholics Anonymous is the first program to use the 12-step method, but many mutual aid programs have adopted the 12-step structure for other addictions.

These 12-step programs often include a sponsorship option, where a successful group member who has reached long-term recovery mentors someone just starting the program.

Find Addiction Therapy Options Near You

If you or someone you love is ready to get help with addiction, the good news is there are many great resources and treatment centers available to help. While searching online can be a great place to start, it’s easy to get overwhelmed with the sheer amount of search results.

Luckily, there are great tools like the Substance Abuse and Mental Health Services Administration (SAMHSA) online treatment locator and their free helpline at 1-800-662-4357 (HELP).

You can also contact your general physician or your local health department to see what treatment facilities and support groups are available in your area. If transportation is an issue, many community-based programs can assist with the logistics of attending meetings and counseling sessions.

Written by

Jessica Miller

Editorial Director

Jessica Miller is the Editorial Director of Addiction Help. Jessica graduated from the University of South Florida (USF) with an English degree and combines her writing expertise and passion for helping others to deliver reliable information to those impacted by addiction. Informed by her personal journey to recovery and support of loved ones in sobriety, Jessica's empathetic and authentic approach resonates deeply with the Addiction Help community.

Reviewed by

• Fact-Checked
• Editor

Kent S. Hoffman, D.O.

Co-Founder & Chief Medical Officer

Kent S. Hoffman, D.O. has been an expert in addiction medicine for more than 15 years. In addition to managing a successful family medical practice, Dr. Hoffman is board certified in addiction medicine by the American Osteopathic Academy of Addiction Medicine (AOAAM). Dr. Hoffman has successfully treated hundreds of patients battling addiction. Dr. Hoffman is the Co-Founder and Chief Medical Officer of AddictionHelp.com and ensures the website’s medical content and messaging quality.