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If addiction has impacted your life, whether through a personal addiction or that of a loved one, you’ve likely heard of both individual and family therapy as potential means of treatment. If you are looking into treatment options, you may be contemplating the differences between individual vs. family therapy and wondering which is right for you.
Individual vs. Family Therapy: Which is Better?
People often compare individual vs. family therapy and ask which is better for the treatment of drug and alcohol addiction. In reality, it isn’t worth comparing the two because each therapy is beneficial and has unique advantages. If you are struggling with addiction, both individual and family therapy have the potential to help you stop using addictive substances and improve your overall functioning and well-being.1
What is Individual Therapy?
Individual therapy is a type of psychotherapy in which a mental health professional works one-on-one with a client to provide personal support to work through mental, emotional, social, and behavioral health challenges. Individual therapy may also be referred to as talk therapy, counseling, or psychotherapy.2
Many different approaches to individual therapy can be beneficial when you are struggling with substance addiction. Some common types of addiction therapy include:
- Cognitive-behavioral Therapy (CBT): Cognitive-behavioral therapy helps people recognize the thoughts and feelings that lead to drug or alcohol use and identify healthy alternative coping strategies to prevent relapse.1
- Dialectical Behavior Therapy (DBT): Dialectical behavior therapy is a type of CBT that can help people with substance use disorders achieve abstinence by developing mindfulness skills, fostering acceptance, increasing distress tolerance, and improving emotional regulation.4
- 12-Step Facilitation Therapy: 12-step facilitation therapy has three main components: acceptance of the problem, surrender to a higher power, and active participation in 12-step programs.1
- Mindfulness-Based Therapy: Mindfulness-based interventions teach mindfulness as a coping skill to help cope with cravings and reduce addictive behaviors. Mindfulness is a practice of nonjudgmental awareness of the present moment. Mindfulness improves self-awareness, reduces emotional reactivity, and promotes acceptance and compassion.3
- Motivational Enhancement Therapy (MET): Motivational enhancement therapy focuses on increasing motivation for behavioral change using motivational interviewing techniques. MET typically only involves four individual sessions. It aims to create rapid change in a short period rather than following someone through the entire recovery process.1
- Contingency Management: Contingency management is a form of reinforcement therapy that provides people with tangible rewards for abstinence. For example, many treatment centers offer patients vouchers for each substance-free urine screen they provide.1
- Rational Emotive Behavior Therapy: Rational emotive therapy is an action-oriented therapy that challenges people to dispute their unhelpful and irrational thinking and replace it with realistic and healthy self-talk.5
- Eye Movement Desensitization and Reprocessing Therapy (EMDR): Eye movement desensitization and reprocessing therapy is a popular evidence-based treatment for post-traumatic stress disorder (PTSD). Because substance use disorder is often comorbid with PTSD, addressing and healing trauma with EMDR therapy may help reduce substance abuse and prevent relapse for those in recovery. EMDR stimulates eye movements to help individuals process traumatic memories and reduce the negative thoughts and physiological arousal associated with them.6
Benefits of Individual Therapy
Individual therapy offers many benefits to those struggling with substance use disorders. If you choose to receive individual therapy, some benefits you may experience are:1,2
- Individualized emotional support and counseling catered to your unique needs
- A private outlet for self-expression, free from the fear of judgment from family or peers
- An opportunity to focus exclusively on your personal growth and healing with the help of a dedicated professional therapist
- Addressing all of your biological, psychological, social, and emotional needs, not just the drug addiction
- Building healthy coping strategies and problem-solving skills, learning to recognize and reframe harmful and unhelpful thinking, identifying triggers for drug use, uncovering underlying traumas that may be contributing to substance abuse, and creating a safety plan and relapse prevention strategy
What is Family Therapy?
When comparing individual vs. family therapy, they differ in that family therapy focuses on the family unit as a whole. The family is considered a system of different parts. A change in one part will create a change in the whole. This means that when one person in the family struggles with alcohol or drug addiction, all members of the family will be affected.7
Family refers to a group of two or more people with a close emotional bond. Family looks different for everyone, and as such, family therapy can look different as well. It can involve parents, siblings, spouses, aunts and uncles, in-laws, grandparents, stepchildren, extended family members, and other relatives.7
Family therapy has two main goals. The first goal is to help everyone in the family learn to provide a healthy level of support to the person struggling with addiction (while also setting appropriate boundaries). The second goal of family therapy is to promote familial healing and strengthen the emotional health of the entire family structure as a whole.7
Types of Family Therapy
Many different types of family therapy are appropriate for families facing substance use disorders. These include:
- Family Behavior Therapy (FBT): Family behavior therapy combines contingency management and behavioral contracting that addresses substance use and other behavioral problems. Therapists encourage family members to utilize behavioral strategies taught in session in the home environment as well.8
- Brief Strategic Family Therapy (BSFT): Brief strategic family therapy involves a family systems approach to treatment in which the problematic behaviors of the person struggling with addiction are thought to stem from unhealthy family dynamics. BSFT consists of 12-16 sessions where the therapist gets to know each member of the family individually, observes family member interactions, and supports the family in shifting negative relational patterns to healthier ways of interacting and relating to one another.8
- Multidimensional Family Therapy (MDFT): Multidimensional family therapy is a collaborative approach to substance abuse therapy for adolescents that involves both the individual’s family and the larger community. Sessions can take place outside of the traditional therapy office and may be conducted in a person’s home, at school, or in other community settings.8
- Functional Family Therapy (FFT): Functional family therapy combines the family systems approach with behavioral therapy techniques. FFT addresses the unhealthy family dynamics contributing to substance abuse and helps improve communication between family members, strengthens parenting skills, and promotes healthy coping strategies and problem-solving skills.8
- Risk Reduction through Family Therapy (RRFT): Risk reduction through family therapy is an integrative treatment approach that addresses substance abuse and PTSD, as well as other co-occurring mental health issues in adolescents who have experienced trauma. The goal of RRFT is not only to reduce substance abuse and trauma-related mental health symptoms but also to improve family dynamics and increase protective factors that help prevent victimization.9
- Behavioral Couples Therapy (BCT): Behavioral couples therapy is a type of family therapy, especially for married or cohabiting couples where one partner is battling a substance use disorder. BCT focuses on supporting and sustaining abstinence by improving relationship functioning and communication.9
Benefits of Family Therapy
Family therapy may be beneficial if you struggle with a substance use disorder. Some benefits you and your family may experience are:7,9
- Better treatment outcomes—research indicates that treatment programs that include family therapy have better outcomes than those that do not.
- Benefits for the whole family—family therapy provides benefits to the whole family, not just the individual struggling with the substance use disorder.
- Reduction of the burden of stress on other family members
- Prevention of other family members from developing a substance abuse problem
- Decrease in the risk of dropping out of treatment
- Promotion of long-term recovery and discouragement of relapse
- Increase in medication adherence and reduction in psychiatric symptoms in people suffering from both substance use and mental health disorders
- Creation of lasting change through family members helping to improve client motivation
- Potential for generational healing—family therapy can help families break generational patterns that contribute to unhealthy dynamics, which can prevent substance abuse in future generations.
- Positive effects on client engagement in treatment
Integrating Individual vs. Family Therapy into a Treatment Plan
There is no one-size-fits-all approach to addiction therapy and treatment. A comprehensive treatment plan usually integrates several different therapeutic modalities to provide care that addresses all aspects of your experience: physical, mental, emotional, social, and spiritual. Treatment may include individual therapy, family therapy, group therapy, medication, and peer-support programs, such as 12-step meetings.1
Proper assessment is an important first step in creating an individualized treatment plan that is tailored to your unique needs. When you first seek out addiction treatment, you will undergo a biopsychosocial evaluation to determine all of the factors affecting your substance use. This will include a thorough medical and family history, past traumatic experiences, and a chronological record of substance use.9 This initial assessment will not be the only one during the treatment process, however. Treatment plans must be continually monitored and assessed for effectiveness so that treatment is meeting your ever-changing needs.1
If you or a loved one are considering addiction treatment, call 800-926-9037 (Who Answers?) to speak to an addiction treatment support specialist about options to meet your specific and unique needs.
- National Institute on Drug Abuse. (January 2018). Principles of Drug Addiction Treatment: A Research Based Guide (Third Edition).
- National Institute of Mental Health. (June 2021). Psychotherapies.
- Garland, E. & Howard, M. (2018). Mindfulness-based treatment of addiction: current state of the field and envisioning the next wave of research. Addiction Science and Clinical Practice, 13(14).
- Dimeff, L. & Linehan. M. (June 2008). Dialectical Behavior Therapy for Substance Abusers. Addiction Science and Clinical Practice, 4(2): 39-47.
- Albert Ellis Institute. (n.d.). Rational Emotive Behavior Therapy.
- Schafer, I., Chuey-Ferrer, L., Hoffmann, A., Lieberman, P., Mainush, G., & Lotzin, A. (March 2017). Effectiveness of EMDR in patients with substance use disorder and comorbid PTSD: study protocol for a randomized control trial. BMC Psychiatry, 17:95.
- Substance Abuse and Mental Health Services Administration (SAMHSA). (2013). Family Therapy Can Help: For People in Recovery From Mental Illness or Addiction.
- National Institute on Drug Abuse. (January 2014). Principles of Adolescent Substance Use Disorder Treatment : A Research-Based Guide. Family Based Approaches.
- Substance Abuse and Mental Health Services Administration (SAMHSA). (n.d.). SAMHSA Advisory: The Importance of Family Therapy in Substance Use Disorder Treatment.