Types of therapy are essential in substance use and mental health recovery by helping you build emotional regulation, change unhelpful behaviors, and strengthen the skills you need for long-term stability. 

Whether therapy takes place in inpatient programs, outpatient settings, or through virtual sessions, the right approach can meet you where you are and adapt as your recovery needs change.

Evidence-Based Therapies That Support Substance Use and Mental Health Recovery

Evidence-based therapy gives you repeatable tools for changing patterns that keep substance use and mental health symptoms stuck: how you think, how you regulate emotion, and how you respond in high-risk moments. 

Below are three of the most widely used, research-backed approaches.

1. Cognitive Behavioral Therapy (CBT) for Thought and Behavior Change

CBT is built on a practical idea: what you do is strongly influenced by what you think and expect will happen. 

In recovery, this often shows up as automatic thoughts, learned routines, and short-term reward loops. CBT breaks this cycle by reshaping thoughts and practicing healthier responses.

Core CBT skills you practice (and why they work):

• Functional analysis (triggers → thoughts → feelings → behavior → consequences): You map your “use chain” or symptom chain so you can identify the highest-leverage interruption points (for example: sleep loss, conflict, boredom, cravings).
  
• Cognitive restructuring: You learn to challenge distorted thoughts and replace them with accurate, action-focused alternatives, which helps reduce relapse risk driven by anxiety or depression.
  
• Skills + exposure/behavioral experiments: You practice coping skills in feared situations, such as cravings or social pressure, so your brain learns you can handle them without using or spiraling.
  
• Relapse prevention planning: You build specific “if–then” plans (If I’m offered alcohol at a party, then I text my support person, step outside, and leave within 10 minutes if cravings rise).

Large reviews and meta-analyses show CBT is effective across many mental health conditions, with strong evidence for anxiety and meaningful benefits for depression.¹

For alcohol and drug use disorders, meta-analyses show CBT outperforms minimal treatment and is widely recognized as an evidence-based approach for substance use recovery.²

Where CBT fits best in care:

• Outpatient and virtual: CBT is highly structured and “skills-forward,” which makes it well-suited for weekly outpatient sessions and telehealth formats. Many programs also use CBT workbooks and between-session practice to reinforce learning.
  
• Inpatient/detox step-down: CBT concepts (trigger mapping, coping plans, cognitive tools) are also useful during stabilization, but most people benefit most when those skills are practiced repeatedly in real-life contexts after discharge.

2. Dialectical Behavior Therapy (DBT) for Emotional Regulation and Distress Tolerance

DBT’s “dialectical” stance means: two things can be true at once. You accept where you are right now, and you work toward change. That combination is powerful for people who feel trapped in shame cycles (“I messed up again, so why try?”). 

DBT is especially helpful when intense emotions drive impulsive behaviors, including substance use to escape distress. While grounded in the same evidence-based foundation as CBT, DBT places greater emphasis on emotion regulation, distress tolerance, and relationship skills.

Skills you build in DBT (and how they support recovery):

• Distress tolerance: Tools to get through spikes of craving, panic, anger, or grief without making things worse in the next hour (the time window where relapse often happens).
  
• Emotion regulation: Skills to reduce vulnerability (sleep, nutrition, routine), label emotions accurately, and shift emotional intensity before it becomes overwhelming.
  
• Mindfulness: Training attention so you can notice cravings and urges as experiences that rise and fall rather than commands you must obey.
  
• Interpersonal effectiveness: Communication and boundary tools to reduce conflict, which is a common trigger for both use and symptom flare-ups.

DBT and substance use specifically (DBT-SUD):

DBT has an adapted form designed for substance use disorders (often called DBT-SUD). Reviews describe DBT-SUD as adding targeted strategies for addiction complications (like relapse cycles, “all-or-nothing” abstinence thinking, and disengaging from treatment after slips).³

In fact, meta-analytic work also supports DBT as a credible evidence-based option, particularly when emotional dysregulation and self-destructive coping drive symptoms.⁴

Where DBT fits best in care:

• Higher-intensity outpatient (IOP/PHP) and after inpatient: DBT shines when you need frequent skills coaching, structured practice, and consistent accountability.
  
• Virtual DBT: DBT skills groups and individual DBT sessions are commonly delivered via telehealth, which can increase access and consistency.

3. Family Therapy and Systems-Based Approaches to Holistic Healing

Substance use and mental health challenges are shaped by the environments you live in, including stress, family dynamics, trauma, and communication patterns that can increase relapse risk. 

Family and systems-based therapies address these factors by changing the relational and environmental patterns that sustain symptoms, strengthening communication, boundaries, problem-solving, and supportive roles without placing blame.

What “systems-based” therapy often targets:

• Communication that escalates conflict: Reduces criticism/contempt and increases repair and clarity.
  
• Boundaries and consistency: Shifts from chaos or over-control to predictable expectations
  
• Recovery-supportive routines: Help your home environment reduce triggers (substances accessible, isolation, unstructured time).
  
• Co-occurring mental health needs: Aligns the family around how to respond to panic, depression, irritability, or trauma symptoms without reinforcing avoidance or use.

Strong evidence in adolescent and adult substance use:

Research shows multiple evidence-based family approaches for adolescent substance use treatment improve interactions, monitoring, and support within the home.⁵

Systematic reviews show that involving family members in treatment can reduce substance use and improve family functioning, reinforcing that recovery outcomes improve when the home environment changes alongside the individual.⁶

Where family therapy fits best in care:

• Inpatient/detox: Family sessions can stabilize discharge planning and reduce immediate post-discharge relapse risk by aligning expectations and support.
  
• Outpatient/virtual: Ongoing family work can be the difference between “white-knuckling” recovery and building a sustainable lifestyle. Virtual sessions often make attendance easier for partners or relatives with work and distance barriers.

With this understanding, the next step is choosing the therapy or combination that fits your symptoms, recovery stage, and support needs.

Choosing the Right Type of Therapy Based on Your Needs

Choosing the right therapy starts with understanding what is currently interfering with your recovery.

1. If your challenges are driven by using substances to cope with stress, anxiety, or routine cues

CBT may be the best fit. CBT helps you recognize the thoughts and behaviors that keep symptoms stuck and replace them with practical coping strategies you can use in real-world situations.

2. If you struggle most with intense emotions, impulsive reactions, or rapid mood shifts 

DBT may offer stronger support and is especially helpful if emotional overwhelm, conflict, or shame cycles make it hard to stay regulated long enough to use coping skills.

3. If your recovery is influenced by family stress, relationship conflict, or lack of support at home 

Family or systems-based therapy can be critical. These approaches change your environment and help the people around you support recovery in healthier, more consistent ways.

You may also need to consider where you are in the recovery process. The intensity and structure of a therapy program often matter just as much as the therapy approach itself when determining the level of support you need to make and sustain progress.

Accessing Trusted Therapy Programs at Oceanrock Health and South Coast Counseling

Reaching out for help can feel overwhelming, especially if you are unsure where to start or what kind of support you need. It is okay to take this step slowly. 

For flexible support that fits into your daily life

Oceanrock Health offers outpatient and virtual therapy options. These programs let you focus on recovery while staying connected to daily routines and support systems. Virtual sessions make consistency easier when work, travel, or family limit in-person visits.

For more structure, medical supervision, or support during early recovery

South Coast Counseling provides inpatient and detox programs. These programs help you stabilize, feel safe, and build a strong foundation before moving to the next phase of care. Inpatient treatment is especially helpful when symptoms feel overwhelming or extra support is needed early in recovery.

No matter where you begin, you do not have to do this alone. The right program can give you the tools, guidance, and steady support needed to move forward, one step at a time.

Sources:

1. ‌Hofmann, S. G., Asnaani, A., Vonk, I. J. J., Sawyer, A. T., & Fang, A. (2012). The Efficacy of Cognitive Behavioral Therapy: a Review of Meta-Analyses. Cognitive Therapy and Research, 36(5), 427–440. https://doi.org/10.1007/s10608-012-9476-1
2. Citation Magill, M., Ray, L., Kiluk, B., Hoadley, A., Bernstein, M., Tonigan, J., & Carroll, K. (2019). A Meta-Analysis of Cognitive-Behavioral Therapy for Alcohol or Other Drug Use Disorders: Treatment Efficacy by Contrast Condition. In Journal of Consulting and Clinical Psychology. https://addictions.psych.ucla.edu/wp-content/uploads/sites/160/2020/01/JCCP-A-meta-analysis-of-cognitive-behavioral-therapy-for-alcohol-or-other-drug-use-disorders-Treatment-efficacy-by-contrast-condition.pdf
3. ‌Dimeff, L., & Linehan, M. (2008). Dialectical behavior therapy for substance abusers. Addiction Science & Clinical Practice, 4(2), 39–47. https://doi.org/10.1151/ascp084239
4. ‌Haktanir, A., Karisse, C., & Callender, A. (2020). Meta-Analysis of Dialectical Behavior Therapy (DBT) for Treating Meta-Analysis of Dialectical Behavior Therapy (DBT) for Treating Substance Use Substance Use. https://epublications.marquette.edu/cgi/viewcontent.cgi?article=1601&context=edu_fac
5. ‌Horigian, V. E., Anderson, A. R., & Szapocznik, J. (2019). Family-Based Treatments for Adolescent Substance Use. Child and Adolescent Psychiatric Clinics of North America, 25(4), 603–628. https://doi.org/10.1016/j.chc.2016.06.001
6. ‌Esteban, J., Suárez‐Relinque, C., & Jiménez, T. I. (2022). Effects of family therapy for substance abuse: A systematic review of recent research. Family Process, 62(1), 49–73. https://doi.org/10.1111/famp.12841