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Psychotherapy Overview for Alcohol and Substance Abuse

Mark Dombeck, Ph.D.

Psycho-Social Treatments:

A variety of psychological and social (psychosocial) strategies for treating drug and alcohol dependence have been developed, each offering a different level and type of support to persons recovering from drug or alcohol dependence. Treatments are often mixed and matched to fit the individual, as resources (money and/or health insurance) permit.

Psychotherapy (Group and Individual Formats)

The term "psychotherapy" encompasses a broad spectrum of interventions led by therapists, for the benefit of patients. A partial list of the things that psychotherapy may attempt to accomplish would include but not be limited to:

  • providing a safe and trustworthy forum in which hurting people can discuss their present-day issues and problems
  • providing a safe and trustworthy forum in which hurting people can talk about how they came to be the way they are (exploration of past experience)
  • promoting the sharing and releasing of shameful and emotionally toxic experiences in a way that promotes personal empowerment and feelings of self-worth and belonging.
  • teaching specific coping skills for managing specific problems and symptoms
  • providing a place where people can make friends and give and get interpersonal support
  • providing a parental-style figure who gives authoritative guidance to those people who are in need of external guidance
  • providing a model and personal experience of what trust-worthy relationships look like (so that such relationships can be pursued outside of therapy)

From among this list, at least four specific therapy agendas may be discriminated:

  • Supportive psychotherapy aims to offer patients a safe and trustworthy forum in which they may discuss the troubling aspects of their lives. The therapist strives to listen to the patient, who is encouraged to share emotionally. When needed, the therapist may act as a strong guide/authority figure, outlining things that the patient should do and not do. This type of therapy is not exploratory and doesn't delve into the past histories of patients. It is most helpful for interpersonally and emotionally fragile patients, and/or patients who become disorganized when confronted with stressful situations and memories.
  • Coping-focused psychotherapy aims to teach patients specific and practical ways to cope with specific problems such as Depression, Anxiety, Panic and Substance Abuse relapse prevention. The best and most effective forms of coping-focused psychotherapy are those that are based on scientific research. Most any form of Cognitive-Behavioral Therapy is recommended. Relapse Prevention programs are highly recommended.
  • Social skills/interpersonal/growth psychotherapy aims to teach patients to become more emotionally and socially mature in their dealings with others. For a variety of reasons, many addicts tend to have poor interpersonal skills and to deal with their emotions in self-destructive ways. Social skills/interpersonal/growth psychotherapy (usually performed in a group therapy context) helps patients to learn about and practice (within the session amongst each other) healthy ways of communicating with others.
  • Exploratory psychotherapy aims at helping people to uncover the links between past experiences (trauma, violence, abuse, etc.) and present behavior. Because exploratory forms of psychotherapy often involve recalling painful past events, this sort of therapy can be disorganizing and itself traumatic to fragile recovering persons, and to dually diagnosed patients with psychotic or other severe symptoms, it is not recommended. There is much evidence in fact that healing from many forms of mental illness can proceed just fine with out any need to bring up past traumas (the most effective forms of psychotherapy for improving functioning being the coping focused varieties). However, exploratory psychotherapy (and particularly a behavioral form known as exposure therapy) is useful in treating many anxiety and trauma based disorders, and should not be ruled out as an option for recovering persons with stable sobriety under their belts.


Reader Comments

ERAZEX should be banned - sutappa ray - Jul 1st 2010

My daughter have gone into substance abuse getting high on erazex the whitner thinner. This site is very helpful for parents like me who have no clue what all can happen or symptoms to look for.Pls do a movement so that more awareness is created about the danger this seemingly useful product can create, All school children are getting affected,there are deaths also because of usage.WHEN MOSTLY CHILDREN ARE USING COMPUTER WHY DO WE NEED ERAZEX?? WE CAN DO WITH A WHITNER STICK IF SO NEEDED.


psychotherapy? - Bill.G - Jan 19th 2009

Psychotherary is like using reverse psychology on people to scare them into stop using. Believe me a Doctor can use psychotherapy all day alone, but if the individual isn't ready to stop going to drug or alcohol rehab won't change a person. Now I do support prevention & intervention programs such as self-supported groups, due to the fact that those individuals have successfully kicked the habit, and can share directly with others their close to death experiences.

I would like to share a true experience after I was hired in as a     Counselor at a Alcohol/Drug treatment facility. I had three                  years clean after a painful relapses. I had just completed my         internship program at this same place, but I was asked to stay                  on to be hired in as a Counselor, and the bottomline is people with addictiongs do look for Counselors with Educational/Street know-         ledge then bookworm Counselors. Today working with individuals               on the Street level is more effective then on the Adiminstrative            level.

My tools that I use with my clients is to gain their confidents and their trust. Secondly; I share real facts about why I started using drugs & alcohol, and in all reality our beginning all started almost the same way peer-preasure (wanting to be cool). Sure we all experienced Resentment, Rejection, Nelection, Physical Abuse, and we all did at one time or the other used these events as excuses to get high.

Which brings the question up, Do drug and alcohol users need someone to psycholanalyze us?, when we know what and why we do the things we do? Don't get me wrong about Doctors or a Psychotherapy. I have a friend that I consult at times, and believe me they are the reasons why I have been in recovery 10 years after a relapses.

So in closing drug & alcohol users please think about the following including yourself. The love ones that you have hurt by stealing, cheating, and lying to in order to get help to keep your habit going. If you have Children, Grandchildren, and Great Grandchildren think about how they are looking at you. Inconclusion be good to yourself.





stop drug addiction - jane doe - Jun 18th 2008

its true the effects of alcohol depends abit on the person body size and what have you! but bottom line is it affects you! more often than not,negatively!!


drug - reena - Jun 6th 2008

When a person drinks alcohol, the alcohol is absorbed by the stomach, enters the bloodstream, and goes to all the tissues. The effects of alcohol are dependent on a variety of factors, including a person's size, weight, age, and sex, as well as the amount of food and alcohol consumed.



e - eliza_1990 - May 27th 2008


"Drug spoiled the man's life ,so please stop the Drug".my requests to all the Drug addicters.




Tired and Emotional in Iowa ? - JR - May 13th 2008

Agreed - this site is very difficult to get to grips with.  Enough to drive one to drink - oh sorry, been there, done that, never again ...

Best regards,


Alcohol in Iowa - - May 12th 2008

Bit difficult to know where this "comprehensive site" is going - or, indeed, where it is coming from. How many Steps along the way ?