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Drug and Alcohol Counseling

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Medically Reviewed By: Diana Vo, LMFT

January 5, 2022 (Originally Published)

May 9, 2023 (Last Updated)

Table of Contents

If you are ready to commit to addiction recovery, the thought of drug and alcohol counseling might feel intimidating. It doesn’t need to be that way, though.

The latest data from SAMHSA (NSDUH 2020) indicates that 40 million adults in the US have substance use disorder and 28.5 million have alcohol use disorder. This is a huge jump from the previous National Survey on Drug Use and Health (NSDUH 2019), largely due to the pandemic and the effects rippling outward.

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What is more disturbing is the huge gap that remains between those needing substance use treatment and those obtaining professional help. Most estimates suggest only one in ten diagnosed with substance use disorder receive any form of treatment.

For anyone concerned about what will unfold during counseling sessions, today’s guide to drug and alcohol counseling will show you that you have nothing to fear and potentially much to gain.

an image of two people discussing drug and alcohol counseling

What to Expect at Drug and Alcohol Counseling Programs

Drug and alcohol counseling sessions take place at both inpatient rehab and outpatient rehab. Sessions are held in a therapist’s office.

Counseling and therapy typically comes after you have completed detox, whether at home or in a medical detox center. Occasionally, therapy in various forms begins during detox at residential rehab.

If you are undergoing medication-assisted treatment for alcohol use disorder or substance use disorder, FDA-approved medications are used in combination with the various forms of counseling and therapy we’ll outline today.

The duration and frequency of therapy sessions will depend on the level of care you need. At the least intensive point on the continuum of care, a traditional outpatient program might include one or two hours of weekly therapy sessions. An IOP (intensive outpatient program) will offer from 9 to 15 hours of weekly therapy, with a PHP (partial hospitalization program) delivering full-time therapy over 30+ hours each week.

For those unable to access a treatment center, virtual IOPs allow you to engage with therapy sessions remotely. All you need is an internet connection and a computer or smart device to benefit from virtual counseling for substance abuse – more about online therapy below.

Therapy takes on many different forms, and the most effective treatment centers will create a personalized plan so you get the most out of counseling and therapy.

These are some of the most common forms of counseling you will encounter when pursuing a course of addiction treatment:

  • Group counseling
  • Individual counseling
  • Behavioral therapies
  • Family/marriage therapy

Group counseling

With group counseling, you’ll benefit from the peer support of others going through similar experiences.

A therapist or counselor will lead this group session, touching on topics related to addiction and recovery in general.

While group counseling sessions do not afford the same sense of individual attention as individual counseling, you’ll benefit from being exposed to a wide range of viewpoints, and you can also draw strength from others in the same kind of situation as you.

The most personal and searching work is performed in face-to-face sessions with your counselor, though.

Individual counseling

Individual addiction counseling sessions allow you to work closely with a therapist, probing the specifics of your addiction and the way it has impacted you.

Your therapist will help you to identify the people, places, things, and emotions that trigger you into harmful behaviors like substance abuse.

Once you have identified what precipitates your substance use, you can work with your therapist to avoid these where possible. Where it is impractical to avoid triggers, you will create healthier alternative coping mechanisms. Learning to implement these in the real world can mean the difference between sustained recovery and relapse.

While many forms of therapy can be effective, research suggests that behavioral interventions like CBT (cognitive behavioral therapy) and motivational interviewing are especially beneficial for treating addictions. The best therapist will customize therapy to meet your specific needs.

Behavioral therapies

When you undertake addiction treatment at a reputable rehab using evidence-based programs, these are among the most common behavioral therapies offered:

  • CBT (cognitive behavioral therapy): CBT helps you to recognize the thought patterns and the behavioral responses that lead to substance abuse. You will learn how to interrupt these responses, and you’ll also discover how to implement healthy coping strategies to help you navigate life’s everyday stressors.
  • Trauma-focused CBT: This variant of CBT accounts for any underlying traumas and the way they can impact behaviors. The more you become aware of this link, the more easily you can break the link between trauma and substance abuse.
  • DBT (dialectical behavior therapy): DBT is a specific form of CBT first developed to treat the symptoms of BPD (borderline personality disorder), but now used to treat a wider spread of mental health conditions and dual diagnosis (addiction with co-occurring mental health disorder).
  • Interpersonal therapy: You’ll gain the skills you need to build a sober social support network. This should help you to combat loneliness and depression as you pursue ongoing recovery from addiction.

Studies show that behavioral therapy (when combined with medication-assisted treatment and motivational therapies) can improve outcomes in the treatment of alcohol use disorder.

Family/marriage therapy

Addiction is a family disease. Not only do the effects of substance abuse affect the whole family, but family dynamics can also influence the way you engage with addiction treatment.

When therapy sessions involve the family members of the person grappling with addiction, this is a valuable opportunity to repair unraveled relationships with the help of a neutral third-party experienced in fixing problems just like yours.

Family therapy sessions will ensure you improve your communication while at the same time strengthening your conflict-management skills. You will get the chance to see how your behaviors are affecting the family, and family members can discover how to best help you without enabling your addiction.

Most good recovery centers offer some form of family therapy, and SAMHSA recommends family therapy in its Treatment Improvement Protocols.

an image of a women in an online drug and alcohol counseling session

Online Drug and Alcohol Counseling

Ultimately, substance abuse causes myriad effects on your life. Alcoholism and drug abuse can impact you physically, emotionally, socially, and financially. You could even run into legal problems because of substance abuse, and you’ll almost certainly cause damage to the family unit.

Fortunately, online therapy means that barriers to addiction treatment are being continually eroded.

Research indicates that those who receive online therapy for the treatment of substance use disorder achieve more favorable outcomes than those who receive no addiction therapy.

When adapting therapeutic approaches for online delivery, some make a smoother fit than others, CBT and motivational interviewing in particular.

CBT, as outlined above, can help you to identify addiction triggers and replace substance use with healthier coping strategies.

MI (motivational interviewing) is another approach that can be molded neatly into an online format. During MI sessions, your therapist will lead a structured conversation helping you to appreciate how your life would improve if you stopped using alcohol or drugs.

Not only are traditional avenues of addiction treatment underused – just 10% of those with addiction engage with treatment – but they also have high dropout rates. Online therapy could help to plug this gap for those either not seeking treatment or not sticking with traditional addiction therapy.

This analysis of studies shows that virtual therapy could help you to moderate substance use, both immediately following treatment and over the long term. The authors pointed out that more research is needed to explore the effectiveness of various online therapies.

Other research shows that online addiction therapy can sometimes be more effective than traditional therapy, both in terms of success rates and retention.

Renaissance Recovery’s Addiction Counseling Program

Evidence-based treatments underpin all our addiction counseling programs here at Renaissance Recovery Center.

In the case of both alcohol use disorder and opioid use disorder, medication-assisted treatment (MAT) can be beneficial. FDA-approved medications can help ease both cravings and withdrawal symptoms, but this treatment is most effective when delivered in combination with counseling.

Psychotherapies like CBT and DBT are central to all our treatment programs. Working closely with a qualified counselor, you’ll discover the people, places, things, and emotions that trigger you to use substances. Crucially, you’ll also learn how to implement healthy coping strategies in place of substance abuse. These skills will be invaluable as you move down the continuum of care or transition back into life at home or at a sober living home.

Once you complete your treatment program, you will have created an aftercare plan – sometimes known as a continuing care plan – tailored to you and the stage you are on your recovery journey. Equipped with access to an alumni program, follow-up counseling, and therapy, as well as a comprehensive relapse prevention plan, you can leave substance abuse in the past, moving forward to embrace sustained sobriety. Take the first vital step right now and reach out to Renaissance at 866.330.9449.



At Renaissance Recovery our goal is to provide evidence-based treatment to as many individuals as possible. Give us a call today to verify your insurance coverage or to learn more about paying for addiction treatment.

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Joseph Gilmore has been in the addiction industry for three years with experience working for facilities all across the country. Connect with Joe on LinkedIn.

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