Addiction is different for every single person experiencing it. From the duration of substance use to the presence of any accompanying mental illnesses or trauma, each individual requires a tailored treatment plan. With this in mind, professionals may apply many different, evidence-based approaches in the treatment of drug and alcohol addiction (substance use disorders or SUD). This list is by no means exhaustive, but it covers many of the common methods used in treatment centers and private practices nationwide.
Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy, abbreviated CBT, is a type of psychotherapy. This talk therapy involves structured one-on-one sessions with a mental health counselor. The goal of CBT is to reshape negative thinking to enable participants to effectively meet life’s challenges.
CBT can be a very effective treatment, either alone or with other therapies, for mental health disorders and addiction. It helps those in treatment to manage symptoms, prevent relapse, learn coping mechanisms, and overcome emotional trauma.1 Through a goal-oriented approach, those in CBT will open up about thoughts and feelings to their therapist. Sessions often involve learning techniques such as resilience, stress management, assertiveness, and relaxation.
Counseling: Individual and Group
Counseling can take place in an individual or group session. By speaking with a licensed counselor, individuals gain a better understanding of their addiction and the factors contributing to it. A wide array of treatment modalities and therapeutic approaches can be effective, including group sessions. In group therapy, each person may share their stories and learn from the experiences of others, decreasing feelings of loneliness and isolation common to active addiction.
Dialectical Behavioral Therapy (DBT)
Developed in the 1980s as a treatment for borderline personality disorder, Dialectical Behavioral Therapy is a type of CBT that teaches behavioral skills. These lessons help participants to manage emotions, improve relationships, resolve conflict, and handle stress. It has been successful in the treatment of those with addiction and various mental health diagnoses.2
Through a series of individual therapy sessions and group education, DBT focuses on skill development in four key areas.
- Mindfulness – Accepting and being present in the moment.
- Distress Tolerance – Coping with negative emotions rather than seeking to escape them.
- Emotion Regulation – Learning to manage and change intense, problematic emotions.
- Interpersonal Effectiveness – Becoming more assertive and prioritizing self-respect.
Many people may require therapeutic approaches in addition to traditional talk therapy. Experiential therapy is effective for the treatment of substance use disorders because it deeply engages the emotions of the patient. Its main purpose is to explore subconscious thoughts and emotions through guided imagery, role-playing, and other activities.
Examples of experiential therapy include:
- Art therapy
- Music therapy
- Equine therapy and other animal-assisted therapies
- Creative writing or poetry therapy
- Adventure therapy (wilderness expeditions, ropes courses, ziplining)
- Play therapy
- Drama therapy (psychodrama)
Eye Movement Desensitization and Reprocessing (EMDR)
Eye Movement Desensitization and Reprocessing (EMDR) is a psychotherapeutic treatment originally created to address the emotional distress and symptoms created by trauma.3 More than 30 positive controlled studies have been done on EMDR therapy since its creation in the 1980s.
EMDR is an eight-phase treatment involving the combination of eye movement and a variety of other elements. It includes attention to three time periods: the past, present, and future. Through the analysis of past trauma, patients work through current distress and develop the attitude required for positive future actions.
Family Treatment Approach
Family involvement is key to the treatment of any health problem, and addiction is no exception. Because everyone close to the patient experiences the negative effects of substance use, the primary challenge of rehabilitation is broadening treatment focus from the individual to the entire family.4
In family therapy, a counselor facilitates discussions and problem-solving sessions with the entire group, as well as with select individuals or subgroups. There is also typically an educational component so that spouses, siblings, parents, and children may develop a better understanding of the disease model of addiction.
Originating from Carl Roger’s person-centered approach to therapy, motivational interviewing is a counseling method that provides incentives to change behavior. It is often used in the treatment of addiction and the management of physical illnesses and ailments.
Through motivational interviewing, patients are inspired to alter the behaviors that negatively impact their health.5 It is ideal for those who are unmotivated or unprepared for change, or those who are hostile to the idea of transformation.
Psychodynamic therapy is built on the theories of psychoanalysis. It focuses on boosting awareness of unconscious thoughts and behaviors, developing insights into motivations, and resolving conflicts.
As a type of talk therapy, psychodynamic therapy consists of open conversation about current concerns, fears, desires, and goals.6 It is distinguished from other similar therapies by its emphasis on overcoming contradictory feelings. By understanding these repressed emotions, patients learn how their past can affect current decision-making, behavior, and relationships.
All addiction treatment programs focus on preventing relapse, but the program called relapse prevention refers to a specific intervention approach. A skills-based, cognitive-behavioral approach, relapse prevention seeks to identify potentially triggering situations and methods to overcome them.7
Relapse prevention strategies include:
- Challenging positive expectancies surrounding substance use.
- Developing coping skills that address potential relapse triggers.
- Learning how to say “no” in an assertive, clear way.
- Planning for emergencies: sudden, intense urges and cravings.
- Reinforcing confidence in the ability to abstain from drug and alcohol use.
- Participating in the cognitive restructuring of thinking traps and cognitive distortions.
12-Step Facilitation Therapy
This type of facilitation is an active engagement strategy designed to inspire active affiliation with 12-step self-help groups. The three key ideas of 12-step facilitation are acceptance of the disease model of addiction, the surrender of oneself to a higher power and adherence to recovery activities, and active involvement in AA or NA meetings and related activities.8
Benefits of this type of therapy include helping patients to achieve lasting recovery, providing a community of peers for support, and enabling patients to access a judgment-free environment.
Addiction Treatment Information
Since its founding in 1978, The National Association of Addiction Treatment Providers has provided leadership, advocacy, training, and support to ensure access to the highest quality of addiction treatment. If you or a loved one are struggling with addiction, browse the NAATP Addiction Industry Directory to find licensed addiction service providers near you, and explore consumer resources that offer guidance in selecting a treatment provider.
 Cognitive Behavioral Therapy. Mayo Clinic, https://www.mayoclinic.org/tests-procedures/cognitive-behavioral-therapy/about/pac-20384610.
 Dialectical Behavioral Therapy. Psychology Today, https://www.psychologytoday.com/us/therapy-types/dialectical-behavior-therapy.
 What is EMDR? EMDR Institute, Inc., https://www.emdr.com/what-is-emdr/.
 Substance Abuse Treatment and Family Therapy. NCBI, https://www.ncbi.nlm.nih.gov/books/NBK64269/.
 Motivational Interviewing. Psychology Today, https://www.psychologytoday.com/us/therapy-types/motivational-interviewing.
 Psychodynamic Therapy. Psychology Today, https://www.psychologytoday.com/us/therapy-types/psychodynamic-therapy.
 Relapse Prevention (RP) (MBRP). Recovery Research Institute, https://www.recoveryanswers.org/resource/relapse-prevention-rp/.
 12-Step Facilitation Therapy. National Institute on Drug Abuse, https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral-4.