Individual therapy for substance use offers you a personalized, evidence-based path to recovery, tackling both addiction and the underlying factors that drive it. Through one-on-one sessions with a licensed therapist, you work on building coping skills, understanding triggers, and reinforcing positive behaviors to support long-term sobriety. Research shows that individual therapy is the most widely used form of treatment for substance use disorders and that the quality of the therapeutic alliance between you and your therapist is one of the strongest predictors of positive outcomes [1]. Whether you’re new to treatment or looking to enhance your existing plan, this guide explores core modalities—like cognitive behavioral therapy, dialectical behavior therapy, motivational interviewing, trauma-focused approaches, experiential techniques, and mindfulness-based practices—that can help you stabilize your mental health and improve your chances of lasting recovery.
Understand individual therapy
What is individual therapy?
Individual therapy is a form of psychotherapy where a trained professional guides you through thoughts, emotions, and behaviors in a confidential, one-on-one setting. It differs from advice given by friends or family because it’s provided by licensed psychologists, counselors, or social workers who follow structured, evidence-based approaches tailored to substance use disorders. Treatments often combine cognitive and behavioral techniques, motivational strategies, and coping skills training to help you reduce or stop substance use. Individual therapy is frequently integrated with medication-assisted treatment (MAT) and other behavioral therapies to create a comprehensive, personalized plan suited to the severity of your addiction and unique needs [1].
Why choose individual therapy?
- Builds a strong therapeutic alliance based on trust and open communication, which boosts retention and engagement
- Offers customized interventions that address your history, triggers, and co-occurring mental health issues
- Enables deep exploration of underlying causes such as trauma, stress, or emotional dysregulation
- Fosters skill development for coping with cravings, managing stress, and preventing relapse
By working one-on-one, you receive focused attention and immediate feedback, making it easier to set personal goals and monitor progress as you move toward sustained recovery.
Core therapy modalities
Cognitive behavioral therapy
How CBT works
Cognitive behavioral therapy (CBT) is a structured, short-term approach that helps you identify and change negative thought patterns contributing to substance use. In 12 to 16 sessions, you learn to spot moods, beliefs, and situations that trigger cravings. Your therapist guides you through exercises to challenge unhelpful thoughts and replace them with healthier, realistic alternatives [2].
Benefits of CBT
- Develops practical coping strategies for high-risk situations
- Increases self-awareness and problem-solving skills
- Reduces the likelihood of relapse over time
- Improves emotional regulation and decision-making
For a deeper dive into techniques and session structure, see cognitive behavioral therapy for addiction.
Dialectical behavior therapy
How DBT works
Dialectical behavior therapy (DBT) integrates core CBT techniques with mindfulness and acceptance strategies. Over six months to a year, you participate in weekly one-on-one sessions focused on four skill modules: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. This blend of skills training and coaching helps you navigate intense emotions without turning to substances [2].
Benefits of DBT
- Lowers relapse rates by about 40%
- Strengthens your ability to tolerate distress and reduce impulsive reactions
- Enhances capacity for healthy relationships and communication
Learn more about how it can support you in dialectical behavior therapy for substance use.
Motivational interviewing
How MI works
Motivational interviewing (MI) is a brief, goal-oriented technique designed to resolve ambivalence and boost your intrinsic motivation for change. Through open-ended questions, reflective listening, and affirmations, your therapist helps you explore discrepancies between your current behaviors and broader goals, keeping you engaged in treatment [1].
Benefits of MI
- Increases treatment retention and commitment
- Empowers you to set and follow through on personal recovery goals
- Works especially well for individuals who feel resistant or uncertain about change
Discover how MI can enhance your recovery in motivational interviewing for addiction.
Trauma-focused therapy
Why trauma therapy matters
Unresolved trauma often underlies substance use, driving cravings and relapse. Trauma-focused therapy provides a safe space to process painful memories, learn grounding techniques, and develop healthier coping strategies. Addressing trauma directly can reduce the urge to self-medicate and foster deeper emotional healing. Effective addiction treatment integrates behavioral therapies to treat both substance use and underlying trauma [3]. Explore options in trauma therapy for addiction recovery.
Experiential therapy
Examples of experiential techniques
Experiential therapy uses hands-on, interactive activities to help you explore emotions and behaviors in real time. Common methods include:
- Adventure therapy, which uses outdoor challenges to build resilience
- Art therapy, encouraging expression through creative projects
- Role-play exercises to practice coping in realistic scenarios
These approaches can break through resistance, spark insight, and reinforce adaptive behaviors. Learn more about active modalities in experiential therapy addiction treatment.
Mindfulness-based therapy
Mindfulness practices
Mindfulness-based therapy teaches you to cultivate present-moment awareness through:
- Breathing exercises to calm anxiety
- Body scans to release physical tension
- Guided meditation for stress reduction
By strengthening your ability to observe thoughts and feelings without judgment, you can better manage cravings and interrupt automatic substance-seeking behaviors. Read about tailored programs in mindfulness based addiction therapy.
Choose the right therapist
Credentials and experience
Seek a therapist licensed in psychology, counseling, or social work with specialized training in substance use disorders. Certifications in trauma therapy or specific modalities like CBT and DBT signal advanced expertise. Don’t hesitate to ask about their experience treating clients with profiles similar to yours.
Personal fit
Your comfort and trust in a therapist are critical. During an initial consultation, notice how they listen, explain concepts, and respond to your concerns. A positive rapport encourages honesty and makes it easier to tackle sensitive topics.
Insurance and accessibility
Most insurance plans, including those under the Affordable Care Act, cover behavioral therapies like individual therapy for substance use [1]. Verify your benefits, ask about sliding-scale fees if needed, and explore telehealth options for added convenience.
What to expect in sessions
Building a therapeutic alliance
A strong therapeutic alliance—rooted in trust, empathy, and collaboration—is one of the top predictors of successful outcomes. Your therapist will encourage open dialogue, set clear expectations, and adapt interventions to your evolving needs.
Setting treatment goals
Early sessions focus on defining specific, measurable goals. You might aim to reduce substance use days, learn five new coping skills, or improve emotional regulation. Clear objectives help track progress and maintain motivation.
Tracking your progress
Regular check-ins and homework assignments keep you accountable. You may use self-report questionnaires, journaling, or apps to record cravings and mood shifts. For structured exercises, consider relapse prevention therapy exercises.
Improve recovery outcomes
Preventing relapse
Recognizing triggers
Identify the situations, emotions, and social contexts that increase your risk of relapse. Common triggers include stress at work, interpersonal conflict, or reminders of past substance use.
Developing coping skills
Equip yourself with alternative strategies—like problem-solving, relaxation techniques, and distraction methods—to handle high-risk moments. For guided activities, see coping skills training addiction and therapy for cravings and triggers.
Addressing co-occurring disorders
Many individuals with substance use disorders also experience depression, anxiety, or PTSD. Integrating treatment for both conditions can improve outcomes. While individual therapy addresses the behavioral aspects of addiction, combined approaches or referrals ensure you receive comprehensive care.
Enhancing motivation
Sustaining long-term recovery often requires periodic boosts to your motivation. Techniques like goal-setting, self-monitoring, and positive reinforcement can reignite your commitment. If you struggle with motivation, explore therapy to rebuild motivation.
Stabilizing mental health
Maintaining emotional balance supports your journey. Techniques such as mindfulness, distress-tolerance skills from DBT, and body-based approaches can help you manage anxiety and stress before they lead to relapse.
Your journey to recovery
Long-term commitment
Recovery is a lifelong process. Even after initial goals are met, ongoing check-ins and maintenance sessions help you stay on track. Many find that moving to less-frequent “maintenance” therapy sessions preserves gains and prevents complacency.
Ongoing support
Beyond individual sessions, consider complementary group therapy for peer connection and mutual accountability [4]. Engaging with a supportive community—whether through 12-step meetings, alumni gatherings, or wellness groups—reinforces the skills you develop in therapy.
When to adjust your plan
It’s normal to reassess your treatment as you progress. If you encounter setbacks, discuss them with your therapist to refine goals, introduce new modalities, or increase session frequency. Staying flexible and proactive ensures your recovery plan continues to meet your changing needs.
