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How Does Individual Therapy In Drug And Alcohol Rehab Work?

“Without my therapist, I wouldn’t have known where to start”
“I had to learn why I was addicted before I learned how to change”
“In therapy, I discovered that I’d been depressed long before I drank my first shot”

Drug and alcohol rehab is, by its very nature, a communal experience. This is by design, as group therapy and support has consistently been proven as a crucial component of recovery. However, without individual therapy, recovery falls flat.

Individual therapy for substance abuse

There are a number of reasons individual therapy in drug and alcohol rehab is crucial. These include:

  • Explore the circumstances that led to your addiction
  • Identify the coping mechanisms you need to rebuild
  • Discover any co-occurring disorders, which caused or are a result of your addiction
  • Learn to rebuild important coping mechanisms
  • Build skills to manage your triggers
  • Learn to manage your emotions before they become overwhelming

While you will work on many of these factors in group sessions, you need to know how they affect you as an individual in order to implement them in your own life.

With this in mind, let’s discuss how individual therapy works in rehab.

Individual therapy in drug rehab

Individual therapy in drug rehab consists of regular one-on-one sessions with a therapist chosen for you by the institution. These therapists are trained in a range of modalities, which they can use to adjust treatment for each resident.

Here are some of the treatment modalities used by individual therapists in rehab, and when they are most effective.

Talk therapy

Talk therapy is always a component of individual therapy. In order for the therapist to get to know you, you need to share your background and context, along with your history of drug or alcohol use and how you came to be admitted to rehab. The therapist will ask questions and give measured responses that help uncover factors you may never have thought of.

However, for some people, talk therapy is effective far beyond the first stages of individual therapy. Talk therapy can have the benefit of uncovering triggers, exploring the why of these triggers, discovering methods for sustainable change, and more.

Talk therapy is also instrumental in identifying and treating co-occurring disorders. It is particularly useful for people who are new to the therapeutic process and have not thought in-depth about their upbringing and personal growth.

Cognitive-behavioral therapy (CBT)

Cognitive-behavioral therapy (CBT), on the other hand, is more directed than general talk therapy. CBT works by identifying troubling thoughts and testing them against reality. Your therapist will help you identify these thoughts and break them down so that you can test them effectively.

With repeated use of these techniques, your thoughts begin to change, until they are no longer triggers for unhealthy or addictive behaviors.

An example would be the thought that “I need a drink to get through parties.” This is actually a combination of a number of thoughts:

  • parties are dangerous
  • I need to act a certain way at parties
  • I need alcohol to act that way

You would then challenge each of these thoughts on their own, coming to understand exactly why they don’t match with reality.

Existential therapy

Technically, existential therapy exists in the context of other therapies. Irvin Yalom, author of the textbook on existential therapy, describes it as a collection of approaches and techniques used by a range of different therapists as part of their therapeutic processes.

With therapies like CBT, you may feel that there are issues you just cannot address. It is one thing to challenge anxious thoughts about real-life situations. However, it is much more difficult to challenge thoughts of meaninglessness, purpose, and death.

Using existential therapy techniques, your therapist will listen to your existential concerns and delve into why they are so troubling for you. They will not offer easy solutions to life’s biggest questions, but rather will help you explore how you can work towards personal answers or learn to be okay with the questions.

Many recovering addicts are struggling with existential questions relating to the world as a whole as well as their personal lives. Therapy in an addiction context should not ignore these questions, as recovering addicts may use drugs and alcohol to shut them out rather than letting them be.

Individual therapy in addiction recovery

The role of individual therapy in addiction recovery cannot be understated. It is necessary for rehab to be effective for each individual person. Techniques learned in rehab do work in general, but you need to know how to implement them in your own life.

There are also personal issues that cannot be dealt with in a general group setting. While recovering addicts have certain triggers and symptoms in common, no one’s lives are exactly the same.
In drug and alcohol rehab, you will be assigned an individual therapist for regular one-on-one sessions. This will set up the framework of your recovery.


  1. Kienast, Thorsten; Foerster, Julia Psychotherapy of personality disorders and concomitant substance dependence, Current Opinion in Psychiatry: November 2008 – Volume 21 – Issue 6 – p 619-624
  2. 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. https://doi.org/10.1016/j.psc.2010.04.012
  3. Yalom, I., 2001. Existential Psychotherapy. Enskede: TPB.
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