Types of Therapy for Alcohol Misuse

When you think of getting help for alcohol addiction, what comes to mind? Chances are either Alcoholics Anonymous (AA) or a residential rehabilitation center come to mind. While these are certainly two effective options, there are many more choices than we might realize when it comes to treating alcohol misuse. In fact, there are various types of therapy for alcohol use disorder that we can turn to for help, such as cognitive-behavioral therapy for alcoholism, talk-based alcoholism therapies, and many others. Let’s take a closer look at them.

Talk-Based Alcohol Therapy

Talk therapy, otherwise referred to as psychotherapy, is the most common form of therapy, and it can help us build coping strategies and skills to stop or reduce drinking. While a talk-based alcohol therapy session can take place in a group or family setting, it’s most often done in a one-on-one setting with a licensed therapist or psychologist.

During sessions, our therapist might help us get to the root cause of our drinking and develop a roadmap for healing. They might also help us better understand and manage cravings and stay motivated to achieve sobriety goals. Talk therapy often takes time; it can last for several weeks or span several months.

Cognitive-Behavioral Therapy for Alcoholism

Cognitive Behavioral Therapy (CBT) has proven particularly effective in treating alcohol misuse. It was first developed as a clinical approach to managing mood disorders, but was later adapted to treat alcohol use disorder (AUD) and other forms of addiction.

The idea behind CBT is that certain patterns of thoughts can lead to maladaptive, or harmful, behaviors, such as continued substance use. The theory suggests that we can start to change our behavior by identifying and changing any negative thoughts and emotions that might lead us to engage in drinking.

While we can technically practice CBT on our own, it’s often more effective to see a licensed counselor or therapist who can help guide us through this process. They can help us explore the positive and negative consequences of continued alcohol use, challenge harmful beliefs, and equip us with strategies for coping with cravings and avoiding high-risk situations.

Another important component of CBT is building or strengthening various skills, such as family or other social relationships, emotional regulation, and problem-solving skills.

Research indicates that cognitive-behavioral therapy for alcoholism is beneficial even after treatment has concluded, since we can carry the skills we’ve learned with us into our new life. Some studies have noted that CBT can be effective with as few as five sessions, though we’re likely to see greater results by sticking with it for longer.

Interestingly, current research is focusing on how to produce even more powerful effects by combining CBT with medications for alcohol misuse and other behavioral therapies. A computer-based CBT system has shown to be effective in helping reduce alcohol use following other treatments.

Dialectical Behavioral Therapy (DBT)

Dialectical Behavioral Therapy (DBT) is another type of talk therapy that was initially developed to treat people with long-term suicidal behaviors, and it has since been effectively applied to treating alcohol misuse.

The main goals of DBT are to teach us to live in the moment, develop healthy ways to cope, regulate our emotions, and improve our relationships with others. As it relates to alcohol misuse, DBT treatment usually focuses on reducing substance use, managing cravings, eliminating behaviors associated with alcohol use, increasing social support, and encouraging positive and healthy activities. Similar to CBT, a therapist guides us through this process.

There are four main strategies and techniques used in DBT:

• Core Mindfulness: This is about staying in the present moment and paying attention to what’s happening inside us (thoughts, feelings, sensations, impulses) as well as what’s happening around us (what we see, hear, smell, and touch) in nonjudgmental ways.
• Distress Tolerance: This is about helping us accept ourselves and our current situation. DBT teaches several techniques for handling a crisis (such as a craving for alcohol), including distraction and self-soothing.
• Interpersonal Effectiveness: This is aimed toward helping us develop relationship skills, such as learning to listen and communicate more effectively, dealing with challenging people, and respecting ourselves and others.
• Emotional Regulation: This involves learning to more effectively navigate powerful or negative feelings to prevent us from acting on impulse

Research has shown that DBT is effective for people who struggle with alcohol addiction and other substance abuse disorders.

Motivational Interviewing as a Form of Alcohol Addiction Therapy

Motivational interviewing (MI) is designed to help us resolve ambivalent feelings, set direct goals for self-improvement, and stay motivated to achieve them.

A therapist for alcoholism can help encourage us to examine the negative consequences of alcohol use and explore any discrepancies that arise between where we are and where we want to be. They can also help us address any resistance to change that might be holding us back and increase our acceptance of change.

Motivational interviewing can be a particularly powerful technique for treating alcohol misuse since many people feel powerless against addiction and can benefit from increased motivation to take action against it.

Motivational interviewing incorporates four basic principles in therapy, including expressing empathy, rolling with resistance, developing self-efficacy, and developing discrepancy. This technique is often used in conjunction with other forms of therapy.

Expressive Arts Therapy

Play therapy, art therapy, music therapy, drama therapy, sand therapy, and other expressive arts can provide an alternative medium to express, process, and integrate our thoughts and feelings surrounding the recovery process. In fact, many rehab centers offer art and music therapy to their patients.

The purpose of expressive arts therapy is to help us relax, express how we feel, and stay occupied with a positive activity. Art and music therapy have also been shown to alleviate symptoms of depression and anxiety, two of the most common mental health problems which afflict people with alcohol use disorder.

Creative artistic expression helps us tap into emotions and needs that might be difficult to express through more traditional forms of communication. These mediums are a tangible way to help us build new insight and reconcile emotional conflicts.

12-Step Facilitation Therapy for Alcoholism

While the 12-Step approach of Alcoholics Anonymous (AA) and related programs might not be for everyone, it resonates with many people worldwide, especially those who find the spiritual element and community focus of the program helpful in their journey. 12-Step Facilitation therapists are familiar with the program and can help us work through the steps and process what goes on in meetings in a more private setting.

Online Therapy

These days we can find just about anything online, and therapy is no exception! Online therapy has been around for years, but really took off during the COVID pandemic that kept us locked inside with our habits, which, for many of us, got a lot more challenging to cope with. Online therapy can incorporate elements of CBT and DBT and has the added benefit of allowing us to connect with a qualified professional without needing to leave home or disrupt our schedule — all while maintaining maximum privacy.

Yoga and Meditation

The science-backed benefits of mindfulness are well documented, and both yoga and meditation are great ways to harness the power of being in the moment to coast through cravings and get in touch with our authentic selves. In the words of meditation expert Jon Kabat-Zinn, “The little things? The little moments? They aren't little.” Whether we choose the physical practice of yoga or the more introspective practice of meditation, we can tap into the magic of those moments and use them to build momentum for our alcohol journeys.

The Bottom Line About Alcohol Therapy

While this list is by no means exhaustive, these are some of the more common forms of therapy for alcohol misuse. They have all proven effective in helping us manage cravings, reduce consumption, and prevent relapse. Keep in mind, however, that recovering from alcohol misuse takes time. We can’t expect to see results from trying one form of therapy only once — or even twice. The more patient and consistent we are, the greater our chance of seeing results. And if you try one type of therapy and don’t find it effective, don’t give up! There are many other options out there.

Reframe is another alternative. We’ve helped millions of people cut back on their alcohol consumption and enhance their physical, mental, and emotional well-being.