Mental health refers to a person’s overall psychological well-being. The goal of mental health therapy is to restore psychological balance if it has been disrupted. Drug addiction refers to a substance use disorder involving prescription or illicit substances or alcohol. The goal of addiction therapy is to help an individual overcome their physical dependence on drugs and also address underlying mental health issues.
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Different Therapy Types
Many therapies exist that address addiction and mental health issues simultaneously. However, these options differ by the treatment facility and the specific addiction a person struggles with. Addiction and mental health treatments are not one-size-fits-all.
Different types of therapy for addiction and mental health issues may include psychotherapy (talk therapy), substance abuse counseling, behavioral therapies and group therapy, among other interventions.
Some types of therapy will work for some people and will not work for others. Nevertheless, the overall goal of any therapy is to help an individual understand their struggles, whether those involve mental health issues, addiction or both.
A treatment modality refers to any method or approach a medical professional uses to treat individuals with certain diseases, disorders, addictions or conditions.
In the case of mental health, there are several clinical treatment modalities to address and improve an individual’s overall psychological well-being.
Some common treatment modalities for mental health and addiction usually include:
- Psychiatric interventions: individual, group or family psychotherapy
- Behavioral therapy: cognitive behavioral therapy, exposure therapy, interpersonal therapy, dialectical behavioral therapy, psychodynamic psychotherapy
- Somatic treatments: medical interventions, e.g., medication
Individual therapy takes place between a person struggling with a mental health condition or addiction and a medical professional or someone trained in psychotherapy techniques.
Psychotherapy, often called talk therapy, helps people discover and change their troubling thoughts and unhealthy emotional patterns. Individual therapy seeks to address many different factors, including:
- Techniques for coping with stress
- Understanding why certain behavior patterns are unhealthy and how to change those patterns
- Offering emotional support during difficult and turbulent times
Unlike individual therapy, group therapy involves two or more individuals that were previously unfamiliar with each other. These individuals are usually struggling with the same mental health conditions or addictions.
Group therapy provides an avenue for open communication between individuals that share similar struggles. Additionally, techniques that people learn in group therapy can be practiced in a social setting, rather than between an individual and their therapist.
Group therapy seeks to:
- Help individuals with substance use disorders process their thoughts, feelings and actions about substance abuse, as well as those of other people
- Help detect when situations may predispose an individual to use substances
- Facilitate an environment of support and acceptance
Unlike individual or group therapy, family therapy includes a person and their family members, guardians or close friends, and a licensed medical or mental health professional. The goal of family therapy is to treat the family as a whole, with each person contributing a unique and important perspective that helps heal interpersonal relationships.
Family therapy helps families:
- Help individuals who struggle with addiction realize that their behaviors have an impact on everyone in the family
- Improve strained relationships and the general family dynamic
- Offer proper support to the family member who struggles with addiction
Couples therapy (or for those who are married, marriage counseling) involves repairing a strained relationship between a person and their life partner. In the case of couples counseling in the rehab setting, a person with a substance use disorder may seek to mend a relationship that has been broken on account of their substance use.
Couples therapy helps people:
- Help identify and address specific problems in a relationship
- Help couples work collaboratively to address these problems
- Help improve distressed relationships
Intensive therapy refers to therapy where an individual opts to receive more frequent treatment, rather than once or twice weekly.
Intensive therapy aims to:
- Establish a set of rules an individual must obey while in therapy
- Provide educational resources for an individual struggling with a substance use disorder
- Address underlying mental health conditions and co-occurring substance use disorders
Developed in the 1960s, behavioral therapies classified mood disorders, such as depression, as cognitive disorders that could be clinically treated with a combination of emotional, behavioral and cognitive components.
Behavioral therapies generally involve three different cognition aspects including:
- Automatic thoughts,
- Distortions in thinking
- Underlying beliefs.
A licensed medical professional helps individuals define clear and measurable goals by teaching people how to change their thinking patterns.
Cognitive Behavioral Therapy
Cognitive behavioral therapy (CBT) is one of the most popular types of behavioral therapy. As a therapy, CBT has been extensively studied in the fields of psychology and psychiatry. This therapy provides various ways for individuals with substance use disorders to understand and ultimately recover from their addictions.
Frequently, CBT sessions aim to:
- Help a person set goals for their treatment
- Help an individual modify aberrant or unhealthy thought patterns
- Improve someone’s mood
- Help an individual create positive and long-term behavioral changes
Dialectical Behavioral Therapy
Dialectical behavioral therapy (DBT) involves helping an individual who struggles with addiction to pursue a better life. An effective therapy option, DBT encourages individuals to accept themselves, as well as make the changes necessary to live a healthier, more meaningful life independent of their past actions.
Overall, DBT seeks to:
- Help provide the person with the desire to change their current behaviors or behaviors in the immediate past
- Help people enhance their own capabilities
- Help individuals develop newer and healthier behaviors
- Provide people with a highly structured learning environment
Habit Reversal Training
Habit reversal training exposes individuals with substance use disorders to their problematic behaviors. Historically, habit reversal training has been used to treat disorders like hair pulling.
Habit reversal training employs several stages, with the overall goal being to alleviate addictive behavior in the case of substance use disorders.
Habit reversal training aims to:
- Make an individual aware of their problematic and addictive behaviors
- Help someone identify specific stimuli or situations that trigger their addictive behavior
- Help a person develop a healthier habit to replace addictive habits with
- Provide an individual with a supportive environment in which to practice these techniques, as well as teach them how to apply techniques to real-life situations
Rational Emotive Behavioral Therapy
A major premise of rational emotive behavioral therapy (REBT) is that specific events do not cause behaviors or emotions directly. Instead, an individual’s beliefs about specific events may cause the person to become highly reactive.
An effective therapy, REBT seeks to:
- Train individuals to manage their cognitive, emotional or behavioral biases or disturbances
- Help identify unhealthy thoughts, addictive behaviors and other factors that negatively impact someone’s life
- Help people identify beliefs about certain experiences that caused them distress
- Help someone transform negative and unproductive thoughts into positive and productive ones
Systematic desensitization is a therapy developed in South Africa in the 1950s. Systematic desensitization involves gradually and systematically exposing individuals to their addictions, vices or fears.
During systematic desensitization, a person develops a written rationale with a licensed medical professional which details different exposure levels ranging from easy to extremely difficult. In this way, a medical professional can identify a starting and endpoint for desensitization.
In the context of substance use disorders and addiction treatment, systematic desensitization ultimately aims to desensitize individuals to the substance they were dependent on.
Exposure therapy involves repeated exposures to stimuli that an individual identifies with from using substances, or from their underlying fears or other worrisome thoughts.
Similar to systematic desensitization, exposure therapy seeks to alleviate any distress a person feels as a result of experiencing a triggering event or experiencing stimuli. Exposure therapy encompasses various techniques, including exposures that are:
- Gradual or intense
- Long or short
- With and without coping strategies
- Experienced in virtual reality or real life
Cognitive therapy is a subtype of CBT. Cognitive therapy differs from CBT in that treatment plans, and an understanding of addiction, are formulated based on cognitive rather than behavioral elements.
In other words, throughout treatment, a person’s specific disorder is always taken into account, rather than only behavioral changes that extend beyond the disorder. Nevertheless, both therapies help modify an individual’s emotions, behaviors and cognitions (beliefs).
Cognitive Remediation Therapy
Cognitive remediation therapy employs techniques that help an individual improve their overall cognition. Historically, cognitive remediation therapy has been used to treat people who are diagnosed with schizophrenia and who exhibit well-documented cognitive impairments.
Cognitive remediation therapy seeks to improve the activity of neural circuits in the brain that are involved in memory, attention and informational processing by assigning repetitive tasks.
Some of these tasks include:
- Playing games that improve memory
- Participating in games that improve dexterity
- Activities that improve motor control
Motivational interviewing is a type of communication style initiated between a licensed medical professional (therapist) and a person who has a drug or alcohol addiction. A therapist will talk with, or interview, the person to show empathy but still affect change in the individual’s negative behaviors.
Motivational interviewing seeks to:
- Help individuals to deal with feelings of resistance or ambivalence about their behaviors
- Employ reflective listening in a non-judgmental fashion
- Foster a supportive and collaborative environment for both the individual and therapist
The major premise of psychodynamic therapy relies on the subconscious or unconscious elements underlying an individual’s behavior. Psychodynamic therapy is another form of talk therapy with similarities to psychoanalysis.
Recent studies suggest that the efficacy of psychodynamic therapy is questionable. Nevertheless, in the case of substance use disorders, this therapy may help people fully realize their repressed emotions as well as teach them how to express these emotions in a healthy way.
Schema therapy has historically been used to treat individuals diagnosed with personality disorders. Schema therapy involves developing an extensive understanding of an individual’s early maladaptive schemas. Schemas, in this case, are tendencies that developed early in someone’s life. Thus, schema therapy focuses on why a person developed schemas and how they may be affecting the person’s current decisions and behavior.
Mindfulness therapies involve focusing on the present moment and becoming aware of one’s thoughts, feelings or actions. Mindfulness also encourages individuals to tune into universal consciousness.
Through breathing exercises and meditation, mindfulness can help people with mental health conditions or substance use disorders remain focused on the present and not on future events.
Acceptance and Commitment Therapy
As an extension of mindfulness, acceptance and commitment therapy trains people to accept unproductive thoughts through acknowledging that thoughts cannot be controlled. The second aspect involves committing to and embracing a life aligned with a person’s values.
Experimental therapies are those that require more scientific research to determine their efficacy. However, using certain experimental therapies for substance use disorders and mental health conditions may be worthwhile for some individuals.
Many experimental therapies involve the stimulation (excitation) or inhibition of brain cells via an electric current. While there are many advantages to using brain stimulation therapies over traditional prescribed medications, one caveat is that people must be sedated during experimental procedures.
Electroconvulsive therapy involves using electric currents to treat mental disorders. This therapy is used as a last resort if a patient has not seen results from other conventional or first-line therapies.
An individual must be put under sedation and given a muscle relaxant to prevent movement during the procedure. Electrodes that are placed on the brain induce small seizures, which can positively alter a person’s mental state. Over six to 12 months, people may feel reduced depressive symptoms as a result of electroconvulsive therapy.
Eye-movement desensitization reprocessing therapy, or EMDR, was developed in the 1980s to address increasing cases of post-traumatic stress disorder (PTSD).
This therapy stimulates the eyes in eight distinct phases while a licensed medical professional simultaneously guides a person back through uncomfortable memories. The overall goal is for an individual to become desensitized to past traumatic memories.
Nidotherapy is a therapy in which a person has a strong input in every aspect of their care, including treatment. Nidotherapy essentially allows individuals to make choices about their treatment in every step of the process and includes them in important clinical decision making, whereas this approach is normally not the case with other therapies.
Alternative and Holistic Therapies
Besides behavioral, cognitive and experimental therapies, people may be interested in alternative and holistic therapies. From a physiological perspective, alternative therapies are usually considered unorthodox, not well regarded or misunderstood in the medical industry.
Holistic therapies fall under the umbrella of alternative therapies and involve taking into account all aspects of an individual’s health, including spiritual, physical, mental and emotional well-being.
Since addiction and mental health conditions can have a drastic impact on appetite, proper nutrition is critical for people in recovery. Nutrition counseling can be used in conjunction with other therapies to treat mental health conditions and addiction. Nutrition counseling involves educating individuals on healthy dietary changes and habits during and after recovery.
Along with other forms of therapy, recreational therapy can be extremely beneficial for people who are struggling with a substance use disorder or mental health condition. Recreational therapy helps provide a framework for healthy interactions with other individuals and can promote the development of a physically active, healthy and tight-knit community.
Some recreational activities include:
- Dance therapy
- Art therapy
- Equine therapy
- Canine therapy
- Yoga therapy
- Sports activities
- Community involvement
At the Recovery Village, our staff employs various therapies to treat drug and alcohol addiction. If you or someone you know struggles with a substance use disorder, call now to speak with one of our representatives and find out what treatment programs and therapies would best suit your needs.
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The Albert Ellis Institute. “Rational Emotive & Cognitive-Behavior Therapy.” 2018. Accessed May 16, 2019.
Beck, J. “Why Distinguish Between Cognitive Therapy and Cognitive Behavior Therapy?” The Beck Institute for Cognitive and Behavioral Research, 2001. Accessed May 16, 2019.
Bon, Laura, Franck, N. “The impact of cognitive remediation on cerebral activity in schizophrenia: Systematic review of the literature.” PubMed Central, March 2018. Accessed May 16, 2019.
Canadian Agency for Drugs and Technologies in Health. “Couples Therapy for Adults Experiencing Relationship Distress: A Review of the Clinical Evidence and Guidelines.” PubMed Central, October 17, 2014. Accessed May 16, 2019.
Chand S, et al. “Cognitive Behavioral Therapy.” PubMed Central, April 29, 2019. Accessed May 16, 2019.
Daviss S. “Clinical and Therapeutic Treatment Modalities.” American Psychiatric Association (n.d.) Accessed May 16, 2019.
Dimeff, L, Linehan, M. “Dialectical Behavior Therapy for Substance Abusers.” June 2008. Accessed May 16, 2019.
Dubord, G. “Part 12. Systematic desensitization.” PubMed Central, November 2011. Accessed May 16, 2019.
Fonagy, P. “The effectiveness of psychodynamic psychotherapies: An update.” PubMed Central, June 2015. Accessed May 16, 2019.
Hasheminasab M, et al. “Acceptance and Commitment Therapy (ACT) For Generalized Anxiety Disorder” PubMed Central, May 2015. Accessed May 16, 2019.
National Institute on Drug Abuse. “Treatment.” June 2014. Accessed May 16, 2019.
National Institute of Mental Health. “Brain Stimulation Therapies.” June 2016, Accessed May 16, 2019.
National Institute of Mental Health. “Psychotherapies.” November 2016. Accessed May 16, 2019.
Resnicow K, McMaster F. “Motivational Interviewing: moving from why to how with autonomy support.” PubMed Central, March 2012. Accessed May 16, 2019.
Substance Abuse and Mental Health Services Administration. “Chapter 9: Time-Limited Group Therapy.” 1999. Accessed May 16, 2019.
Substance Abuse and Mental Health Services Administration. “Chapter 1 Substance Abuse Treatment and Family Therapy.” 2004. Accessed May 16, 2019.
Turner, M. “Rational Emotive Behavior Therapy (REBT), Irrational and Rational Beliefs, and the Mental Health of Athletes.” PubMed Central, 2017. Accessed May 16, 2019.
Valiente-Gomez A, et al. “EMDR beyond PTSD: A Systematic Literature Review.” PubMed Central, September 26, 2017. Accessed May 16, 2019.
Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.