Individual Therapy for Addiction

Individual therapy can come in various forms, such as cognitive behavioural therapy (CBT) and psychoanalysis. It is a central component of addiction treatment.

Whereas in group therapy, several people in recovery undergo therapy together, in individual therapy, the therapist has a one-to-one session with a single person.

This allows for a much closer relationship between patient and therapist, in which the therapist’s attention can be completely focused on the patient. It gives the therapist an opportunity to build up a rapport with the person in recovery over time, and to learn more about their specific situation and circumstances.

How does individual therapy work?

During an individual therapy session, the person in recovery meets with the therapist to discuss their journey of recovery.

The aim of these sessions is for the person undergoing therapy to achieve a greater understanding of their identity and their relationship with substances.

The therapist must be a qualified mental health worker, with considerable training in the field. It is their job to decide on what kind of therapy will be used, when and where the sessions will take place, what the respective responsibilities of both parties are, and so on.

The therapist may ask the person in recovery at the start of treatment to take responsibility for enacting change in his or her life. After all, therapy is about helping the client to help themselves.

Just as the person in recovery takes on this responsibility, the therapist also has responsibilities: to establish boundaries, and to maintain confidentiality.

Maintaining confidentiality is a moral duty of the therapist. That means that the therapist cannot tell anyone what the person in recovery discloses to them during therapy, apart from under very specific circumstances.

The therapist should inform the person in recovery of these circumstances at the start of treatment. They include:

• If there is an immediate risk of the person in recovery harming themselves.
• If there is an immediate risk of the person in recovery harming others.
• If the person in recovery is unable to provide themselves with food, clothing or shelter.
• If a judge issues a court order, mandating the therapist to give evidence.

Under no other circumstances can the therapist break confidentiality.

Therapy sessions generally last about an hour and happen once a week. They tend to take place in the therapist’s office, although in theory, they can take place anywhere, as long as it is private.

What happens in each individual therapy session depends on what mode of therapy the therapist has chosen. We will go over a few of these in more detail later on in this informational page.

Some of the topics that may come up in an individual therapy session include:

• The person in recovery’s aims for the future
• Whether there is anything preventing them from getting sober
• How they are putting into practise techniques learnt in therapy
• How their recovery is going
• Relationships with friends and family
• Any withdrawal symptoms or cravings

At the end of the session, the person in recovery and the therapist may work together to come up with some aims for the next session. Examples include going to meetings, refraining from substances or putting into practice a technique learned in therapy.

Why do we need individual therapy?

As well as being a disease in its own right, addiction is often a symptom of underlying trauma or mental health issues.

The root cause of someone’s addiction could be anything from being the victim of abuse to depression to self-medicating for physical health problems such as arthritis or back pain.

Group therapy is not the time to be probing for these underlying issues. For group therapy to be effective, the people in recovery need to have already received some individual therapy, so that they understand their own personal issues and relationship with substances. This allows them to share more confidently in a group setting.

For this reason, individual therapy needs to come first. It provides an opportunity for the therapist to really get to the bottom of the person in recovery’s substance abuse. In many cases, the person in recovery may not have a full idea of why they abuse substances – ‘they just do’. Therapy can address this lack of knowledge, and equip the person in recovery with the tools to kick their habit.

Not only can it help them to get clean, but it can also help them to stay clean. It does so by isolating certain ‘triggers’ which cause addicts to use. These triggers are the key reason why people relapse.

There are various different kinds of triggers. Here are some of the most common ones.

• Emotional triggers. Strong emotions, such as grief, guilt or anger, can all trigger substance abuse. Therapy can help those in recovery to learn to identify these strong emotions and the associated desire to use. By understanding the effect that these emotions can have, those in recovery give themselves a chance to step back and resist any cravings that these emotions may cause
• Stressful situations, such as being fired, a relationship breaking down, or even more minor stresses such as being late for an appointment, can all act as a trigger for substance abuse. Therapy can help the person in recovery to identify stressful aspects of their life and either avoid these situations entirely or develop coping mechanisms for any cravings that may arise as a result of these situations
• Social situations. Addicts often form strong mental associations between certain people and places and their addiction. So, for example, someone who suffered from alcohol addiction might have a particular pub or bar that they associate with their addiction or a particular set of friends. It’s really important for the therapist to help the person in recovery identify these social situations and come up with strategies for avoiding them. Addiction is an especially cruel disease because it takes over your whole life; one of the main goals of therapy is to devise a way for the person in recovery to build a new life, free from the associations they created during their addiction

By teaching those in recovery how to recognise and avoid their triggers, individual therapy can make a big impact on someone’s recovery.

What are the benefits of individual therapy

Individual therapy offers a range of benefits to the person in recovery. This article has already covered some of these, but here is a more complete list.

• Individual therapy allows for a greater level of confidentiality compared to other forms of therapy
• In an individual therapy session, the client has the therapist’s undivided attention. This means that the therapist can really focus their energies on the person in recovery, getting to the root of their substance abuse issues and any other related issues, such as mental health issues or trauma
• In individual therapy, the client can set the pace. If he or she feels like the therapy is going too slowly, they can feed this back to the therapist, who will alter the pace to suit their needs. With individual therapy, there is more scope for the person in recovery to exert some control over the therapy session, whereas in a group session everyone’s needs must be met
• In individual therapy, the ‘therapeutic alliance’ – the relationship between client and therapist – can flourish more easily than in a group setting
• It can be easier for the person in recovery to reach a deeper understanding of themselves and their problems in an individual session, where the therapist gets to really concentrate on them and their particular situation
• The client has more control over when one-to-one therapy sessions take place; for instance, if the client has another commitment, a therapy session can be rearranged to accommodate that. Furthermore, if a client needs a one-to-one session promptly (e.g. they have relapsed and need therapy as soon as possible) that can be arranged
• The individual can receive much more focused and personalised treatment in individual therapy

What are the disadvantages to individual therapy?

There are very few disadvantages to individual therapy, but these are the main ones:

• It can be more expensive than group therapy
• Some people in recovery may find it easier to share in a group setting than in a one-to-one session
• Some people in recovery may benefit most from a session with other people who are going through the same things as them, i.e. others in recovery
• Individual sessions can be quite intense since only the client and therapist are involved. Some of those in recovery may prefer a group session for this reason

Most of these disadvantages can be overcome simply by attending group sessions as well as individual sessions. Group therapy sessions and individual sessions are not mutually exclusive: in fact, they complement each other very well. Both forms of therapy have been proven to be highly effective in treating addiction.

What kinds of individual therapy are there?

There are countless varieties of individual therapy, from acceptance and commitment therapy (ACT), to cognitive behavioural therapy (CBT), to dialectical behavioural therapy (DBT), to holistic therapy, and so on.

Rather than going through all of these forms of therapy in detail, we’re going to take a quick look at one of the most common: CBT.

CBT (cognitive behavioural therapy) is a form of therapy which focuses on identifying and modifying negative thought patterns, creating coping mechanisms, and controlling emotional states.

The aim of CBT is to reduce negative behaviours – such as giving in to cravings – by targeting the negative thoughts from which these behaviours arise.

CBT is a blend of cognitive therapy and behaviour therapy and originated in the early 20^th century. It is now one of the most popular forms of individual therapy in addiction treatment.

Here are some pros and cons of CBT:

Pros:

• Multiple studies have confirmed the effectiveness of CBT in treating substance abuse disorders. [1]
• CBT gives those in recovery the tools to deal with stress and anxiety related to addiction.
• It helps those in recovery by teaching them how to spot negative thoughts and how to replace them with positive ones.
• CBT uses ‘homework’, where those in therapy will write down their thoughts and try to change them. This means that the therapeutic process can continue outside of the therapy session.

Cons:

• CBT can be quite time-consuming since it involves both therapy sessions and homework.
• The main focus of CBT is on the individual, and how you can change your thought patterns. It focuses less on external factors, such as family, which can also play a big role in mental health and addiction.

Final thoughts

This informational page has looked at what exactly individual therapy is, how it differs from group therapy, how it works, some and advantages and disadvantages and some of the main forms of individual therapy, including CBT.

As stated above, individual therapy is a very important part of addiction treatment and goes well with group therapy, counselling and detox.

References

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2897895/#R5