Individual Therapy for Addiction Treatment

Medical Reviewer

Libby Pellegrini

About the Reviewer

Individual therapy for addiction treatment is a form of psychotherapy in which an individual works one-on-one with a therapist. Also known as psychosocial therapy, talk therapy, or counseling; individual therapy is an important component of a well-rounded addiction treatment program. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), individual addiction therapy is available at 96% of US treatment facilities.

Individual therapy helps people in recovery from substance use disorders identify and change unhealthy emotions that cause distress and substance-seeking behaviors. One-on-one addiction therapy also provides those in recovery with a safe space to express difficult emotions and experiences related to their substance abuse; while helping them develop new coping mechanisms.

This article explains individual therapy, including how it works, what it helps with, and what to expect from treatment.

Why Individual Therapy is Important for Addiction Treatment

Individual therapy is an important component of addiction treatment programs because it addresses the emotional and psychological needs of individuals who are in recovery from substance abuse. Drugs and alcohol are often used to mask or self-medicate difficult thoughts and feelings. Therefore, once a person has undergone detox, there are often a lot of complicated emotions, thoughts, and past traumas to unpack and process. Individual therapy provides patients with an opportunity to address these challenges and learn new coping mechanisms that support their recovery.

Receiving ongoing individual therapy is also crucial in helping avoid relapse. There are a variety of different situational and psychological factors that can trigger a relapse. Individual therapy can help with the following:

• Environmental triggers: Visiting a place where a person used to consume substances, such as a particular bar, neighborhood, friend’s house, or another location, can trigger a relapse. Individual therapy can help people develop healthy coping mechanisms for when they’re faced with these kinds of triggers.
• Situational triggers: Stressors from work, romantic relationships, family and other life events can influence a person to relapse. Individual therapy can help people learn new, healthy ways of managing daily stress without abusing substances.
• Social triggers: When in recovery, it can be challenging to be in social situations where other people are drinking or using drugs and resist the urge to participate. Psychotherapy can help individuals learn how to have healthier relationships while also helping develop the necessary coping skills for when these kinds of scenarios come up.

Addressing Substance Abuse and Trauma

Many people with substance use disorders have experienced trauma and suffer from post-traumatic stress disorder (PTSD). Individual therapy provides individuals with a safe space to acknowledge and process past traumatic experiences such as:

• Being a victim of physical assault
• Being involved in a natural disaster such as an earthquake, fire, flood, or tornado
• Being a victim of sexual abuse or assault
• Military combat or experiences of war
• Experience as a first responder
• Witnessing a violent crime

By bringing these experiences to light and helping individuals re-envision their role in past events, people have the opportunity to heal old wounds that contributed to their substance abuse.

Continued Individual Therapy After Addiction Treatment

Recovering from drug and alcohol addiction is a life-long process. While the intensive addiction treatment therapies that occur following detox set the stage for recovery, it’s important to have an ongoing treatment plan once an addiction treatment program is complete. Therefore, continued therapy is often recommended for long-term recovery. Maintenance therapy provides individuals with an opportunity to check in with their therapist, make adjustments to their treatment plan, and most importantly, address the new challenges that being in long-term addiction recovery involves.

Benefits of Individual Therapy for Substance Abuse

While individual addiction therapy comes in many forms, the overarching goal of treatment is to help people overcome challenges, develop healthy coping mechanisms, and lead happier and healthier lives, free of substance abuse. Some of the benefits of individual therapy include:

• Encourages honesty and sharing: Individual therapy allows patients to discuss their personal experiences in a private one-on-one setting. This encourages people to express difficult thoughts, feelings, and past traumas that they might not have been comfortable sharing in group therapy or a 12-step program.
• The sense of being heard and understood: Individual addiction therapy provides a safe and judgment-free environment for the patient to express themselves.
• Improved communication skills: During therapy sessions, the therapist will ask the patient questions which encourage them to think critically and communicate their feelings clearly.
• Healthier thinking patterns and greater awareness of negative thoughts: Addiction therapy helps people better understand negative thought patterns and how they influence addictive behavior. Through individual therapy, a person can learn how to replace unhealthy thinking patterns with new, healthier thoughts.
• Greater insights into self: Psychotherapy helps individuals learn more about themselves and the root causes of their substance abuse. This can help people better understand their addictive behaviors and make different choices in the future.
• Ability to make healthier choices: As mentioned above, through individual therapy, individuals learn new coping mechanisms that allow them to make healthier choices that don’t involve alcohol or drug use.
• Better coping strategies to manage distress: Patients learn new ways of managing stress that don’t involve abusing drugs and alcohol.
• Improved relationships: Psychotherapy encourages people to examine their past relationships and patterns; with the goal of forming new, healthy ways of relating to oneself and others.
• Addresses co-occurring disorders and dual diagnosis: Many people use drugs and alcohol to self-medicate. Individual therapy is an opportunity to address co-occurring mental health conditions such as anxiety, depression, bipolar disorder, and PTSD, that impact addictive behaviors.

What Can Individual Psychotherapy Help With?

Psychotherapy is used to address a wide range of behavioral health and mental health disorders. These include:

• Addiction
• Anxiety disorders
• Bipolar disorder
• Depression
• Eating disorders
• Obsessive-compulsive disorder
• Phobias
• Post-traumatic stress disorder
• Substance use disorder

Individual therapy has been found to help people who are experiencing the following:

• Chronic pain or serious illnesses
• Divorce and break-ups
• Grief or loss
• Insomnia
• Low self-esteem
• Relationship problems
• Stress

Individual Psychotherapy vs. Group Therapy

Group therapy provides individuals with a sense of accountability, belonging, community, and peer support that can be very beneficial to the process of addiction recovery. While group therapy is a valuable experience for anyone with a substance abuse disorder, individual therapy provides the chance to examine and treat individual feelings, thoughts, and mental health concerns that aren’t possible to address in a group setting. In other words, the therapist can tailor treatment to an individual’s specific needs and concerns.

Individuals who are concerned about confidentiality or who may not feel comfortable sharing their personal experiences in a group setting might find the intimacy of a one-on-one therapist-patient relationship better suited to their personal needs. Individual therapy provides the opportunity to explore in-depth the root causes of an individual’s addiction while providing new, healthy coping mechanisms.

Different Types of Individual Therapy

A variety of different types of therapy are often used to create a comprehensive and well-rounded addiction treatment program. It’s not uncommon for therapists to draw on several different techniques and therapeutic approaches when treating an individual. Some of the most common forms of individual therapy that are used for substance abuse treatment include:

Cognitive-Behavioral Therapy (CBT)

The most popular type of psychotherapy used to treat addiction, CBT includes several different but related techniques that link an individual’s thoughts and feelings to their actions. A series of therapy sessions aim to break the cycle of negative thoughts causing destructive addiction-related behaviors. Originally developed as a method to prevent relapse when treating alcohol abuse, CBT is known to be effective in treating addiction and a range of mental health issues.

There are several different types of therapy that are derived from or are modified versions of cognitive behavioral therapy. These include:

• Dialectical behavior therapy (DBT)
• Motivational interviewing
• Mindfulness-based cognitive therapy (MBCT)
• Relapse prevention
• Acceptance and commitment therapy
• Cognitive therapy

Dialectical behavior therapy (DBT)

A modified form of CBT, Dialectical Behavior Therapy (DBT), encourages individuals to develop skills that enable them to have improved emotional control and make healthier choices. “Distress tolerance” is a key aspect of DBT. An individual is encouraged to develop new coping mechanisms which help them deal with stressful circumstances without resorting to substance abuse.

Motivational interviewing

This type of CBT aims to resolve ambivalence within an individual and motivate change. Motivational interviewing is designed to enable collaboration between the patient and the facilitator. Individuals are encouraged to feel in charge of their own sobriety, and this has been proven to increase commitment and, ultimately, success.

Mindfulness-based cognitive therapy (MBCT)

This type of CBT encourages mindfulness and meditation as a tool for becoming more aware of one’s own state of mind surrounding challenges, disorders, and contentment. This can aid in developing a greater sense of self-awareness regarding one’s addiction and provide new coping mechanisms for dealing with triggers.

Relapse prevention

Relapse Prevention (RP) is a form of cognitive–behavioral therapy that aims to address high-risk situations for relapse and assist individuals in maintaining desired behavioral changes.

Acceptance and commitment therapy

This form of CBT encourages the acceptance and acknowledgment of an individual’s feelings towards things happening in their life. Once patients learn to accept that their feelings can be justified, they can start to make positive changes to their behavior patterns.

Cognitive therapy

While cognitive therapy is a form of CBT, it’s less focused on behavior and more focused on thoughts, feelings, and beliefs. Treatment aims to overcome the root cause of the problem by addressing the disorder and not just the behavior resulting from it.

Other Types of Individual Therapy

While various forms of CBT are commonly used to treat addiction, other effective types of therapy exist.

Other types of individual therapy used as part of addiction treatment include:

• Contingency Management (CM)
• Psychodynamic psychotherapy
• Rational emotive behavioral therapy (REBT)
• Schema therapy (ST)
• EMDR (eye movement desensitization and reprocessing) therapy
• Sensorimotor psychotherapy
• Existential therapy

Contingency Management (CM)

Contingency Management (CM) relies on the desire for a reward being greater than the desire to use the substance. CM incentivizes patients to reach pre-agreed goals through a voucher-based system or prizes.

Psychodynamic psychotherapy

This type of therapy focuses on the psychological roots of emotional suffering. It places an emphasis on self-reflection and self-examination and uses the relationship between therapist and patient as a window into problematic relationship patterns in the patient’s life. Psychodynamic psychotherapy examines the psychological factors that contribute to a reliance on substances. This includes the role of conflict and the ego, and how it relates to substance abuse.

Rational emotive behavioral therapy (REBT)

REBT teaches that a person’s response to external events affects their feelings and behaviors, not the events themselves. By recognizing this and identifying irrational personal beliefs, individuals can make healthier behavior choices in times of stress or conflict.

Schema therapy (ST)

Schema therapy is an integrative approach that brings together elements from cognitive behavioral therapy, attachment and object relations theories, and Gestalt and experiential therapies. Schema Therapy was devised as an alternative treatment approach when standard CBT is ineffective. Psychotherapists assist patients with identifying their long-held negative beliefs or schemas, many of which relate to early childhood. By changing their associated pattern of thinking, individuals can break the behavior cycle that is detrimental to their life.

EMDR (eye movement desensitization and reprocessing) therapy

EMDR therapy is the practice of helping someone address their trauma through sporadic visual stimulation. EMDR is an effective treatment to help patients heal from traumatic events, adverse reactions, and other triggers associated with their addiction. Unlike other types of therapy, which may be long-term and ongoing, EMDR consists of 8 treatments where the patient is asked to focus on their past, present, and future in relation to traumatic events.

Sensorimotor psychotherapy

This type of therapy is designed to treat trauma, trauma-related disorders such as PTSD, and difficulties stemming from unhealthy attachment patterns in infancy and early childhood. Known as a “body-centered talking therapy,” sensorimotor psychotherapy pairs elements of talk therapy with somatic movement (body movement) to address thoughts, feelings, and somatic experiences related to trauma. The goal is to manage the body, thoughts, and emotions to promote total healing.

Existential therapy

A form of holistic therapy, existential therapy explores personal challenges from a philosophical point of view. Rather than focusing on the past, existential therapy looks at the here and now, exploring a patient’s entire experience as a whole, without judgment.

What To Expect from an Individual Therapy Session

In an individual therapy session, the patient meets with their therapist in a one-on-one setting. The sessions typically last an hour and often take place once a week, however, treatment can occur more frequently if needed. It’s common for a therapist to work with a patient for several months or years at a time.

Several different types of therapies may be used in an individual session, but they frequently include a combination of CBT and psychodynamic therapy.

The first session of therapy is usually focused on gathering information. A therapist will ask the patient about their history with substance abuse, along with their past physical, mental, and emotional health. Often it takes a handful of sessions before the therapist can develop a clear picture of an individual’s personal situation.

During the information-gathering stage, the therapist will also ask the patient to share their concerns about their addiction, what brings them to treatment, and what they’re hoping to get out of therapy.

The effects of psychotherapy are enhanced when there’s a bond between the treatment provider and the patient, and they agree on treatment goals. Therefore, it’s important that individuals feel comfortable with their therapist and believe they are a good fit for them. The initial session provides an opportunity for the patient to ask questions about the type of therapy to be used, how many sessions are required, and what the treatment goals are.

During therapy sessions, therapists will often encourage patients to do all the talking. At first, patients may struggle with talking openly about their feelings, past experiences, and issues surrounding their addiction. Individual therapy can bring up difficult emotions and it’s not uncommon to feel angry, upset, or sad during treatment. With that said, the therapist is there to help the individual feel safe and supported, as these feelings come up.

It’s common for the therapist to ask guided questions, which prompt the patient to explore particular thoughts and feelings. Together, they work towards understanding core challenges and creating positive solutions.

Depending on the type of therapy, the therapist may also prescribe “homework,” such as worksheets, journaling prompts, or other exercises which are designed to help the patient build upon what’s being learned in therapy.

Those participating in individual therapy can expect complete confidentiality from the therapist. The only exception to this rule is if the patient is in immediate danger of harming themselves or others, as permitted by state law. During the first session, the therapist will discuss confidentiality with the patient and may provide written guidelines.

How Effective is Individual Therapy for Addiction Treatment?

For those with substance use disorders, research shows that any form of psychological treatment leads to better treatment outcomes compared with no psychological treatment.

In particular, studies show that cognitive behavioral therapy can be very effective in treating alcohol and drug addiction, in addition to a range of mental health conditions such as anxiety and depression.

Additionally, according to the National Institute on Drug Abuse, the skills that individuals learn through cognitive-behavioral therapy remain after the completion of treatment. In fact, as reported in one particular study, 60% of the patients in the CBT condition provided clean toxicology screens at their one-year check-ups.

There is strong evidence that contingency management (CM) is an effective strategy in the treatment of substance use disorders, particularly, opioids, tobacco, and polysubstance use. Additional research shows that contingency management (CM) can be effective in treating substance abuse disorders by helping reinforce abstinence and other positive behaviors associated with recovery. A 2005 clinical study published in Arch Gen Psychiatry, found that incentive-based addiction treatment may also contribute to improved treatment retention.

Mental Health and Dual Diagnosis

Mental health and substance abuse disorders are intrinsically linked. Dual diagnosis is when an individual has both a substance addiction and a co-occurring mental health or physical disorder simultaneously. At least 20% of people with mental health conditions have a co-occurring substance use disorder. For people with schizophrenia, the number may be as high as 50%. Comparatively, people with substance use disorders are up to 3 times more likely to suffer from a mental health condition such as anxiety or depression.

Psychotherapy has proven to be an effective treatment for a range of mental health conditions. In fact, research shows that psychotherapy is as effective as medication in treating depression. Psychotherapy also works at least as well (if not better) for patients with severe symptoms as it does for those experiencing milder forms of depression.

For individuals participating in an addiction treatment program, individual therapy is an opportunity to effectively address co-occurring disorders, such as anxiety, depression, mood disorders, and eating disorders, while also helping treat issues such as grief and trauma, which may be linked to addictive behaviors.

At the very least, multiple studies show that participating in individual psychotherapy can enhance an individual’s overall sense of well-being, which is important when in addiction recovery.

Learn More About Dual Diagnosis and Addiction Treatment

Risks and Drawbacks of Individual Therapy

While individual therapy has been shown to be effective in treating a wide range of mental health and behavioral health issues, including addiction, some drawbacks do exist, for example:

• It can be overwhelming at first: for people who are not used to opening up about difficult feelings and experiences, individual therapy can feel overwhelming at first. It can also take time for some individuals to trust their therapist.
• Difficult emotions may surface: Individual therapy often involves revisiting difficult moments from one’s past, therefore it’s common for strong emotions such as anger and sadness to come up during therapy sessions.
• Cost: Because individual therapy takes place in a one-on-one setting, the cost is higher than group therapy or attending free 12-step programs.
• Effectiveness: Critics of psychotherapy question its effectiveness. In one early study on the effectiveness of psychotherapy in treating mental health conditions, renowned psychologist Hans Eysenck found that two-thirds of psychotherapy participants either improved or recovered on their own within two years, regardless of whether they had received psychotherapy. However, there’s since been an overwhelming number of studies that confirm the positive benefits of psychotherapy.
• Personality: As mentioned above, psychotherapy works best when there’s a bond between the therapist and the patient. However, not every therapist and patient is going to be a good fit. In fact, research shows that patient and therapist characteristics (such as personality) and the therapist’s use of a specific modality of psychotherapy, affect the results. It may take an individual several tries to find a therapist that they connect with.

Cost of Individual Therapy

The cost of individual therapy varies depending on factors such as location, frequency of treatment, and individual insurance coverage. Some individual therapy providers may offer sliding-scale payment plans, which are based on income.

Individual therapy is usually offered as part of an inpatient or outpatient addiction treatment program and therefore, included in the overall cost of rehab.

Depending on your insurance plan, the cost of individual addiction therapy may be covered to a certain extent. Many insurance plans will cover individual psychotherapy as long as it is evidence-based, run by a professional, and medically necessary.

Additionally, individuals may also receive coverage if individual therapy is part of a comprehensive addiction treatment program.

Even if you have a basic plan, it’s worth consulting your insurance provider. Under the Affordable Care Act in the United States, substance abuse treatment must be covered under ACA insurance plans. ACA plans also can’t disqualify you for having a pre-existing substance use disorder or cap spending on addiction treatment. Many insurance programs such as Medicare, Medicaid, Veterans Affairs (VA) Health Care, along with private medical insurance providers also offer addiction treatment coverage to varying degrees. Therefore, when researching addiction treatment options, it’s important to consult your insurance provider to find out what kind of coverage is available.

Get Help with Individual Addiction Therapy

Regardless of where you are on your addiction recovery journey, individual therapy can have a positive impact on your overall well-being. Through individual therapy, you’ll gain valuable personal insights and develop important coping skills to live a fulfilling life free of alcohol and drug addiction.

If you or a loved one is struggling with drug or alcohol addiction, know that you’re not alone and that treatment is available. We are here to help. Find a drug or alcohol treatment center near you today.