When people think about addiction therapy, they often focus on stopping the behavior: quitting drinking, ending drug use, or breaking free from compulsive habits. While discontinuing the addictive behavior is an important part of recovery, addiction is rarely just about the substance or the habit itself. Addictive behaviors are often attempts to cope with pain, trauma, anxiety, or deep feelings of emptiness. That’s why the most effective addiction therapy doesn’t just focus on the addictive behavior itself, it works to uncover what’s underneath the use: the patterns, the wounds, the unmet needs.
There is a wide range of therapy options for addiction, and while this can be a source of hope, it can also feel overwhelming. If you’re not sure where to start, it helps to understand how addiction treatment is structured and what types of therapy are available.
Understanding Levels of Care
The first step in deciding what the best path for you or your loved one is figuring out the appropriate “Level of Care” as defined by the American Society of Addiction Medicine (ASAM). This framework helps determine the appropriate level of treatment based on a person’s medical, emotional, and social needs. Each level represents a different degree of structure and intensity:
- Level 1 – Outpatient
- What it is: Therapy sessions once or twice per week.
- Best for: Individuals in early- or long-term recovery with strong support systems and minimal risk of withdrawal or relapse.
- Level 2 – Intensive Outpatient/High-Intensity Outpatient (fka Partial Hospitalization Program)
- What it is: Structured programs that offer 9-20 hours of therapy per week
- Best for: People who need more support than Level 1 but do not require inpatient treatment.
- Level 3 – Residential
- What it is: 4-hour care in a live-in, structured environment that provides a combination of medical supervision, community support, individual therapy, and group therapy.
- Best for: People with more severe addictions or limited support at home
- Level 4 – Inpatient
- What it is: The most intensive level of care, typically in a hospital or detox facility.
- Best for: People with severe medical or psychiatric needs in addition to addiction.
Types of Therapy for Addiction
The following evidence-based approaches can be offered across all levels of care:
- Cognitive Behavioral Therapy (CBT)
- What it is: CBT is one of the most well-researched and widely used forms of therapy for addiction. It helps people understand the connection between their thoughts, feelings, and behaviors.
- Why it works for addiction: CBT helps individuals recognize triggers, develop healthier coping skills, and reframe the thoughts that lead to cravings or relapse.
- Best for: Individuals who want a structured, goal-oriented approach that equips them with long-term skills to manage relapse risks and triggers.
- Dialectical Behavior Therapy (DBT)
- What it is: DBT combines mindfulness with emotion regulation, distress tolerance, and interpersonal effectiveness skills.
- Why it works for addiction: DBT teaches practical skills to manage distress, regulate emotions, and tolerate urges without acting on them. These are essential tools for anyone working to break the cycle of addiction.
- Best for: People who struggle with emotional dysregulation, impulsivity, or co-occurring disorders like borderline personality disorder or trauma.
- Motivational Interviewing (MI)
- What it is: MI is a collaborative, person-centered approach that helps people resolve ambivalence and strengthen their internal motivation for change.
- Why it works for addiction: Addiction often comes with internal conflict about stopping. MI helps individuals explore their values, goals, and resistance in a supportive, non-judgmental space.
- Best for: Individuals in the early stages of change or those feeling stuck in cycles of relapse or uncertainty about recovery.
- Family and Couples Therapy
- What it is: This type of therapy focuses on repairing and strengthening relationships impacted by addiction, including communication, trust, and boundaries.
- Why it works for addiction: Addiction often affects the entire relational system. Healing relational dynamics, fostering healthy connection, and reducing enabling patterns can support long-term recovery.
- Best for: Anyone whose addiction has led to strained relationships.
- Trauma-Informed Therapy
- What it is: Trauma-informed therapy recognizes the widespread impact of trauma and emphasizes safety, empowerment, and choice in the healing process.
- Why it works for addiction: Many people turn to substances to manage unresolved trauma. This approach addresses the underlying pain that fuels addictive behavior.
- Best for: Individuals with a history of trauma who need a compassionate, safe space to process difficult experiences.
- Acceptance and Commitment Therapy (ACT)
- What it is: ACT helps people move from avoidance to acceptance, particularly relating to their relationship with thoughts and emotions.
- Why it works for addiction: Instead of trying to control or avoid uncomfortable feelings, ACT teaches people to allow those experiences to be present without letting them dictate behavior, decreasing the reliance on addictive behaviors as an unhealthy coping mechanism.
- Best for: Clients who feel stuck in shame or avoidance, or who want to build a values-based life even in the presence of emotional pain or discomfort.
- Internal Family Systems (IFS):
- What it is: IFS helps people to explore the different “parts” of themselves, such as the part that wants to use substances to cope and the part that feels ashamed afterward.
- Why it works for addiction: IFS fosters self-compassion and insight, helping people understand how addictive behaviors may be protective (but harmful) coping strategies.
- Best for: Clients who feel torn within themselves, particularly those struggling with shame, self-sabotage, or unresolved trauma.
- Group Therapy
- What it is: Group therapy brings people together under the guidance of a therapist to share experiences, offer support, and build connection.
- Why it works for addiction: Addiction often thrives in isolation. Group therapy helps normalize the recovery journey and provides both accountability and encouragement. It also provides a space for individuals to practice new skills in a safe, supportive setting.
- Best for: People seeking accountability, support, and community connection.
- 12-Step Facilitation Therapy
- What it is: A structured approach designed to support people who are involved (or interested) in 12-step programs like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA).
- Why it works for addiction: It encourages connection, accountability, and spiritual growth which are three key components of long-term recovery for many.
- Best for: Those interested in or currently involved in 12-step programs who looking for a structured therapeutic guide to complement that support.
So, What’s the “Best” Therapy?
The truth is, there is no universal “best” therapy. The best therapy for addiction is the one that fits your unique needs, history, and goals. At Mental Bloom Therapy, we focus on helping clients uncover the why beneath the addiction, while offering tools to cope, reflect, and reconnect with their true selves. When you’re able to understand why you needed the substance in the first place, you can begin to meet those needs in healthier ways, building a foundation for lasting growth. Whether you’re seeking help for yourself or a loved one and you’re unsure where to start, reach out and we’ll help you find the path that’s right for you.