Substance Abuse Counselling Techniques


Counselling and therapy for addiction help individuals understand what causes addiction, learn to recognize risk factors for relapse and develop tools for coping with stressful situations. Common techniques include cognitive behavioural therapy, motivational interviewing and dialectical behavioural therapy.


The underlying causes of addiction are mostly genetic and environmental. A person’s genetic makeup can make him or her more prone to sensation-seeking behaviour, more compulsive and more vulnerable to addiction. Life events such as trauma, stress and early exposure to substances of abuse can also affect a person’s vulnerability.


Addiction causes physical and mental side effects. Physical side effects include cravings and withdrawal symptoms, and mental side effects include increased stress and feelings of depression, anxiety or loneliness.


Effective treatment focuses on the genetic and environmental causes of addiction. It also treats the physical and mental side effects.


Detox keeps patients physically safe and as comfortable as possible during withdrawal. Therapy treats the mental aspects. Depending on the severity of the disease, detox can remove cravings and withdrawal symptoms in one to three weeks. However, most people require months or years of continuous counselling to recover from the mental side effects.


The main purpose of counselling and therapy for addiction is to address the underlying causes of the disease to prevent them from causing relapse. Although detox is a vital component of treatment because it helps patients handle withdrawal and ease cravings, it does nothing to address the factors that led to drug abuse in the first place.


Research during the last 30 years has led to advances in evidence-based behavioural therapy for alcohol and drug addiction. The therapies have proved effective in treating substance use disorders in addition to co-occurring mental health issues such as depression, anxiety and obsessive-compulsive disorder.


Today, therapy for substance use disorders is available in a variety of settings, including inpatient residential rehab programs, outpatient rehab programs, sober living communities, private practices and a variety of support groups.


The goal of therapy during a 30-, 60- or 90-day rehab program is to prepare individuals in recovery for life after intensive treatment, but many patients require continued therapy for many months or years after rehab.


Therapy often decreases in frequency and duration as a person learns to cope with the causes of his or her addiction and to handle life’s stressors. However, many experts believe a person never fully recovers from addiction. People who experience a traumatic event or increased stress should turn to therapy to decrease the chances of relapse.


Therapy isn’t a one-size-fits-all process. Different approaches are more appropriate and effective for different people, depending on their age, type of addiction and the factors that contributed to their addiction.


Behavioural Therapies


Addiction treatment centres use behavioural therapies more than any other therapeutic technique, according to the 2014 National Survey of Substance Abuse Treatment Services. Behavioural therapies help patients understand the causes of high-risk behaviour and develop tools for avoiding or coping with high-risk situations.


Cognitive Behavioural Therapy


Cognitive behavioural therapy focuses on learning to reduce problematic behaviour associated with substance abuse. A key theme in CBT is anticipating risky situations and applying coping strategies, such as avoidance or self-control, to prevent relapse.


CBT is one of the most popular therapies in addiction medicine, and Counsellors use it to treat a variety of addictions.


Research has proved CBT can effectively treat addiction to:

  • Alcohol

  • Marijuana

  • Cocaine

  • Methamphetamine

  • Nicotine


During CBT, patients learn to recognize and modify risky behaviour by using a variety of skills. They learn the underlying causes of problematic behaviour so they can fix the problems at their source. They’re able to recognize cravings or triggers and develop strategies for handling those situations. Research shows that patients who learn skills during CBT are able to apply them during real situations later in life.

Dialectical Behaviour Therapy


Dialectical behaviour therapy is effective for patients who struggle to regulate emotions and have thoughts of self-harm or suicide. The therapy emphasizes an acceptance of uncomfortable thoughts, feelings or behaviours to allow patients to overcome them.


DBT has been proved to treat several disorders that co-occur with addiction, including:

  • Mood disorders

  • Personality disorders

  • Eating disorders

  • Self-destructive behaviour


DBT involves relaxation techniques, such as yoga, that help the patient become more aware of thoughts and emotions. They learn skills such as controlled breathing and muscle relaxation to tolerate self-destructive thoughts or urges. The goal is to decrease the frequency and severity of self-harming behaviour and encourage healthy change.