Treatment for alcohol abuse and alcoholism commonly involves a combination of therapeutic elements involving behavioral therapies, medications, and mutual support groups.1 Behavioral therapy may be conducted through both private and group counseling sessions to help patients change their problematic drinking behaviors.1 This page will explore some of the different therapy and individual counseling for alcohol addiction and how it is used in treatment.
What is Individual Therapy for Alcohol Abuse?
If you’ve never participated in an individual therapy session, you may be wondering what it entails and why it is beneficial for treating alcoholism. Individual therapy is one form of treatment for alcohol use disorder where you work one-on-one with a qualified alcohol addiction therapist, counselor, social worker, or psychologist.2 According to the American Society of Addiction Medicine (ASAM), the goal of individualized counseling is to help you develop coping strategies and tools to abstain from alcohol use and maintain abstinence.2
People who abuse alcohol may face problems in many areas of their lives stemming from their addiction. For people in recovery, individual therapy can help address not only the alcohol abuse itself but impairments you may have in other areas of your life as a result of your substance use, such as problems with employment, legal issues, and family or social relationships.2 Individual therapy typically focuses on short-term behavioral goals, meaning that it helps you make concrete changes to the maladaptive or unhelpful behaviors that led or contributed to your alcohol abuse.1,2
What Happens During Individual Therapy for Alcoholism?
During individual therapy for addiction, your therapist may identify specific treatment needs that require referrals for additional assistance, such as medical, psychiatric, employment, or other supportive services. Though the exact number of individual sessions may vary for each individual, people typically attend individual sessions 1-2 times per week as part of their treatment.2
Alcohol addiction therapists are commonly licensed substance abuse counselors, social workers, or psychologists, who empower you to take charge of your life and guide you throughout the process of change.3 Working with these treatment professionals can be beneficial because they are trained to identify substance use disorders, help you understand what type of treatment might be beneficial in your situation, and address any psychological issues that may be standing in the way of your sobriety. They can help you increase your motivation to change, learn to identify triggers, develop coping skills, and develop improved forms of social support.4
What Are Behavioral Therapies?
Behavioral therapies are important components of treatment for alcohol and other substance use disorders. These therapies can include:
- Cognitive-Behavioral Therapy (CBT) is a form of treatment that helps people identify and change unhelpful thoughts and behaviors that played a role in their development of compulsive alcohol use.1,5 During an individual therapy session, you’ll work one-on-one with an alcohol addiction therapist to recognize the feelings and situations that cause you to want to drink and that can lead to relapse. You learn to develop healthier thought patterns and cultivate more helpful ways of coping with stress and other triggers to drink.1,5
- Motivational Interviewing (MI) and Motivational Enhancement (MET) are two therapies that are similar because they are designed to increase your motivation to change.6 You work one-on-one with a therapist for both forms of treatment. MI involves a broader therapeutic approach while MET is specific and focuses on personalized assessment, feedback, and plans to change.6 Both are designed to help you identify the pros and cons of seeking treatment, help you make a plan to change your drinking behaviors, increase your confidence, and help you develop the skills you need to stick with it.6
- Contingency Management (CM) is based on the concept of behavioral reinforcement. It helps people make progress in recovery as they receive rewards for accomplishing certain goals.7,8 This can mean that you receive incentives and reinforcers for making positive behavioral changes; for example, you might receive vouchers to exchange for tangible goods like movie tickets or healthy snacks.7,8
- Dialectical-Behavior Therapy (DBT) was originally developed to treat people suffering from serious mental health issues like chronic suicidality and borderline personality disorder.9 It was then further developed as a form of substance abuse treatment.9 DBT is a comprehensive treatment that involves many components that focus on improving your motivation to change, establishing healthier behaviors (such as reducing or stopping alcohol use), helping you deal with cravings to drink, helping you avoid situations where you want to drink, and improving your social situation.2,9 It involves components of mindfulness, which allows you to focus on the immediate moment, instead of ruminating about the past or worrying about the future.9
- 12-Step Facilitation is a form of individual therapy designed to encourage affiliation with and active participation in 12-step groups.10 The goal is to help you understand and accept that your drug or alcohol use has become unmanageable, that abstinence is necessary for your recovery, as well as to prepare you to participate in 12-step meetings such as Alcoholics Anonymous (AA). AA is a mutual support group that people participate in both during treatment and as an ongoing form of support once they have completed treatment.
Is Individual Therapy More Effective than Group Therapy?
Individual therapy is not necessarily more effective than group therapy, rather, it is the combination of approaches that tends to produce the best results.11 The benefit of group therapy is that it reduces feelings of social isolation, promotes mutual support, and allows people to witness the recovery of other group members.
On the other hand, individual therapy allows time for a person to solely focus on their own issues and concerns, and the relationship between the therapist and client often serves a therapeutic and helpful function.3 #4 Many studies have shown that group therapy is equally as effective as individual therapy for treating substance use disorders.12
Many addiction treatment specialists believe that a combined approach is best because a person receives the benefits of both forms of treatment. One study that examined the benefits of individual vs. group therapy, or a combination of both, found people experienced more treatment involvement, higher levels of peer support, and an increased likelihood of abstinence with a combined approach.13 abstract results and discussion
How Effective Are Behavioral Therapies?
No single treatment approach will be effective for everyone. Individual differences and variable treatment needs are bound to dictate the types and combination of behavioral therapies that are utilized to be most successful in promoting recovery.17 Furthermore, effective treatment for alcohol use disorder commonly involves a combination of individual therapeutic approaches.
Cognitive-behavioral therapy is one of the most researched therapies for alcohol and substance use disorders. Studies have shown CBT to be effective not just for addiction but for treating people with co-occurring disorders (like depression, anxiety disorders, or bipolar disorder). 15 cbt Several studies have shown that dialectical behavior therapy decreased substance use in people with borderline personality disorder; though such a treatment approach may be too extensive for some patients only struggling with alcoholism.9
While there are studies supporting the efficacy of motivational enhancement therapy and motivational interviewing, at least one study failed to show any benefit compared to standard treatment.6 Contingency management has been demonstrated to be effective in research studies and has shown that it helps people decrease substance use and promotes abstinence.15 CM
12-step facilitation is used in a variety of ways. Evidence shows that 12-step facilitation helps people when used on its own, but also works when combined with other therapies or as an add-on component to other treatment. The effectiveness of this approach has primarily been demonstrated for alcohol abuse but may help other types of substance use disorders as well.15
While individual behavioral therapies may no doubt benefit people in recovery, several studies support improved treatment outcomes for adults with alcohol use disorder (or other substance use disorder) when behavioral therapies are utilized in combination with pharmacotherapy (medications such as acamprosate, disulfiram, and naltrexone to decrease drinking behavior and lessen relapse risks).14
Who Determines Which Therapies Are Used?
When you enter a treatment center, substance abuse professionals—such as counselors, therapists, social workers, psychiatrists, and other medical staff—will perform a comprehensive evaluation or an assessment, to determine the best treatment approach for your needs. An evaluation involves a number of components, such as gathering data about your situation to help formulate a diagnosis, establishing the severity of the problem, and examining the associated problems you may have, which can include financial, social, medical, and behavioral concerns. This helps determine the appropriate level of care and types of therapies you may need.16
There may not always be one specific type of therapy that is considered to be the most effective for every person. Rather, the effectiveness of alcoholism treatment may derive from it being customized, dynamic, and multifaceted.1 People may participate in a combination of individual and group therapy, pharmacotherapy, and mutual support groups like AA.1 What works for one person may not work for you, which is why an individualized approach is so important and why you will participate in more than one type of therapy.
Get Help For Alcoholism
If you’re struggling with alcohol abuse or an alcohol use disorder and are ready to seek treatment, American Addiction Centers (AAC) can help. Alcohol.org is a subsidiary of AAC, a nationwide provider of addiction treatment centers.
Our admissions navigators are available 24/7 to chat with you about your treatment options, where our facilities are located and how to check if your insurance covers rehab with us. Call us at 1-888-685-5770 or get a text to speak with someone today; there is no obligation to make any decisions today and all calls are 100% confidential.
Fill out our instant insurance verification form below to help us better serve you when you call. Remember, you’re not alone, recovery is possible and finding freedom from alcohol will be one of the best things you’ll ever do for yourself.
. National Institute on Alcohol Abuse and Alcoholism. (2021). Treatment for Alcohol Problems: Finding and Getting Help.
. Mee-Lee D, Shulman GD, Fishman MJ, Gastfriend DR, Miller, eds. The ASAM Criteria: Treatment Criteria for Addictive, Substance-Related, and Co-Occurring Conditions. The American Society of Addiction Medicine, 3rd ed.
. Sales, A. (1999). Substance abuse and counseling: A perspective. ERIC Digest. Greensboro, NC: ERIC Clearinghouse on Counseling and Student Services. (ERIC Document Reproduction Services No. ED435893).
. American Psychological Association. (2012). Understanding alcohol use disorders and their treatment.
. McHugh, R. K., Hearon, B. A., & Otto, M. W. (2010). Cognitive behavioral therapy for substance use disorders. The Psychiatric clinics of North America, 33(3), 511–525.
. Guydish, J., Jessup, M., Tajima, B., & Manser, S. T. (2010). Adoption of motivational interviewing and motivational enhancement therapy following clinical trials. Journal of psychoactive drugs, Suppl 6, 215–226.
. Psychological Health Center of Excellence. (2018). Contingency Management for Alcohol Use Disorder.
. National Institute on Drug Abuse. (2018). Contingency Management Interventions / Motivational Incentives.
. Dimeff, L. A., & Linehan, M. M. (2008). Dialectical behavior therapy for substance abusers. Addiction science & clinical practice, 4(2), 39–47.
. National Institute on Drug Abuse. (2018). 12-Step Facilitation Therapy (Alcohol, Stimulants, Opiates).
. Friedman, R. (2013). Individual or Group Therapy? Indications for Optimal Therapy. Group Analysis, 46 (2), 164-170.
. Wendt, D. C., & Gone, J. P. (2017). Group Therapy for Substance Use Disorders: A Survey of Clinician Practices. Journal of groups in addiction & recovery, 12(4), 243–259.
. De Moura, A., Pinto, R., Ferros, L., Jongenelen, I., & Negreiros, J. (2017). Efficacy indicators of four methods in outpatient addiction treatment. Archives of Clinical Psychiatry, 44(5), 117-121.
. Ray LA, Meredith LR, Kiluk BD, Walthers J, Carroll KM, Magill M. (2020). Combined Pharmacotherapy and Cognitive Behavioral Therapy for Adults With Alcohol or Substance Use Disorders: A Systematic Review and Meta-analysis. JAMA Netw Open. 2020;3(6):e208279.
. National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition) Community Reinforcement Approach Plus Vouchers (Alcohol, Cocaine, Opioids).
. Center for Substance Abuse Treatment. (1997). A Guide to Substance Abuse Services for Primary Care Clinicians. (Treatment Improvement Protocol (TIP) Series, No. 24.) Chapter 4—Assessment.
. National Institute on Drug Abuse. (2018). Principles of Effective Treatment.