Individual Therapy for Co-Occurring Disorders

When a person has a co-occurring disorder, it is important to treat both the addiction and the mental illness. Individual therapy is one treatment option.

According to the National Institute on Drug Abuse, about half of people who have a substance use disorder will experience a mental health condition at some point during their lives, and vice versa. When someone has both an addiction and a mental health issue, it is labeled as a co-occurring disorder, and the best treatment option is one that addresses both conditions simultaneously. One treatment option that is effective for treating co-occurring disorder is individual therapy. 

What Is Individual Therapy?

As its name might suggest, individual therapy occurs when a client meets one-on-one with a therapist, as opposed to group therapy, in which therapeutic services are delivered in a group setting. Individual therapy is effective, as it allows clients to develop a close therapeutic relationship with the counselor or therapist, so they can process emotions and uncover patterns of thinking and behavior that have contributed to both the mental illness and the addiction. 

How Does Individual Therapy Work?

With individual therapy, clients are typically matched with a therapist who first completes a full assessment of the client, including their life history, family dynamics, living situation, educational/work history, current social relationships, history of mental illness and/or substance abuse, and current symptoms. After completing an assessment, the therapist works with the client to develop a treatment plan, which includes goals to work toward.

Ideally, a client works with the same therapist for the duration of their time in individual therapy. During therapy sessions, clients can process current problems and emotions, and discuss the progress they have made toward meeting treatment goals. Therapists provide feedback, and may help clients to reframe negative thinking, identify negative behaviors that are getting in the way of daily functioning, or help clients build upon their strengths to make positive changes in life. A therapist may also give “homework” or activities that clients should work on between sessions to help them meet their treatment goals. 

Therapist-Client Relationship and Confidentiality 

One critical aspect of the therapist-client relationship is that therapists are trained to behave non-judgmentally and to follow certain procedures, including confidentiality. Within the code of ethics for most therapists, including psychologists, counselors, and social workers, is the mandate to keep communication between the therapist and the client confidential. This means that information shared during therapy sessions cannot be revealed to anyone else without the client’s permission. Therefore, clients can feel comfortable to share their deepest fears, concerns, and struggles with a therapist, without fear that the information will be shared with anyone else. 

There are a couple of notable exceptions. For example, if a client disclosed intent to harm themselves or others, the therapist would be required to report to authorities to protect all involved. Another exception to therapist-client confidentiality is if a client discloses that they have committed some form of child abuse, which would also need to be disclosed to proper authorities. 

Beyond confidentiality, the supportive, nonjudgmental relationship that clients develop with their therapists plays a critical role in the recovery process. Receiving unconditional support and understanding from a therapist can provide people with the environment they need to overcome trauma or other emotional issues that have led to addiction and mental illness. In fact, clients tend to do better in therapy when they perceive that their therapist understands them. The client-therapist relationship can be incredibly healing. 

How Long Does Individual Therapy Last?

The length of individual therapy will depend upon several factors, such as the type of therapy and your individual needs. For the purposes of effective addiction treatment, experts recommend that people remain in treatment for at least three months. Spending more time in therapy is generally associated with better outcomes. 

How Much Does Individual Therapy Cost?

The cost of individual therapy will vary, based upon whether you receive therapy on an inpatient or outpatient basis, the kind of therapy you receive and how often you attend sessions. For example, someone in standard outpatient care may only have one session per week, whereas someone in intensive outpatient services may have appointments twice weekly, which is more costly. 

If you receive individual therapy while in inpatient care, you will pay not only for the cost of therapy, but also for the cost of room and board, since clients in inpatient treatment live on-site at a facility while receiving services. Therefore, individual therapy will end up costing more if you’re in inpatient versus outpatient care.

Ultimately, your cost of individual therapy will depend upon how long you spend in therapy, how many sessions you receive, the credentials of your therapist (psychologist, social worker, counselor, etc.), your insurance coverage (if used) and the type of facility you go to for therapy. 

Is Therapy Covered By Insurance?

Many insurance programs do cover behavioral health services, including individual therapy. Your coverage will depend on your specific insurance plan. Insurance can reduce some of your out-of-pocket costs, but you will likely still have to pay a co-payment for services. A representative from your insurance company can help you determine what your out-of-pocket costs will be.

Not every insurance plan will cover individual therapy, but as a result of the Affordable Care Act, many plans do cover behavioral health services, with benefits being more inclusive than they were before this law. For instance, all insurance programs, including private plans, must offer the same coverage for behavioral health services that they do for medical services, if they choose to cover behavioral healthcare. 

Types of Individual Therapy

All forms of individual therapy give clients an opportunity to meet one-on-one with a therapist to work through personal issues, emotional problems, mental health conditions and addiction issues. Within the realm of individual therapy, there are several modalities that therapists may utilize to treat clients. Several common individual therapies are explained below. 

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy or CBT, is often used in individual therapy for co-occurring disorders. This form of therapy helps people learn to challenge negative, irrational ways of thinking and help them to think in a more positive, balanced manner. An individual therapist who practices CBT can help clients overcome distorted ways of thinking that are contributing to mental health/substance abuse. 

Dialectical Behavioral Therapy (DBT)

Dialectical behavioral therapy, also called DBT, was originally developed to treat patients with borderline personality disorder, but it has been expanded to treat other conditions, including substance use disorders. DBT draws on some of the concepts from CBT, but also helps patients to develop skills for regulating emotions, being more mindful, coping with stress, and interacting with others. 

Eye Movement Desensitization and Reprocessing Therapy (EMDR)

Eye Movement Desensitization and Reprocessing Therapy (EMDR) is an evidence-based treatment for trauma. This form of therapy helps patients to process traumatic memories so they become less frightening, and it has been found to be effective for reducing arousal and negative emotions among those with trauma history. 

Psychodynamic Therapy

This form of therapy helps patients to uncover unconscious processes and patterns of behavior that are causing current problems. In individual psychodynamic therapy sessions, patients can learn to become self-aware and see how the past has an effect on the present. For instance, issues from childhood (such as attachment problems with parents) may be related to current relationship issues, and the tendency to use substances to self-medicate. 

Acceptance and Commitment Therapy (ACT)

Acceptance and commitment therapy, abbreviated as ACT, is a broad form of therapy that helps clients to accept their emotions, become more open to new experiences, and be mindful of bodily sensations. ACT also allows people to become more psychologically flexible, so they can accept setbacks, as well as be committed to their values and goals. 

Interpersonal Therapy

This form of therapy is based upon the idea that psychological problems occur because of problems within a person’s relationships. For instance, depression may develop because of complicated grief after the loss of a loved one, or because of high conflict in an important relationship. By working through relationship issues, a person finds relief from psychological distress. 

Benefits of Individual Therapy

Individual therapy comes with numerous benefits. If you are considering individual therapy for a co-occurring disorder, you may find that this treatment option comes with the following advantages:

• Flexibility in scheduling appointments around other obligations, such as work
• The ability to develop a working relationship with one therapist
• A safe space to discuss and process challenging personal situations
• The opportunity to receive treatment for both mental illness and addiction from the same provider 
• Comfort in knowing that what you discuss in therapy is confidential 

Individual Therapy for Addiction and Mental Health Treatment

If you’re seeking individual therapy for mental health or an addiction and you’re in the Denver area, Denver Mental Health and Counseling is here to help. In addition to offering individual therapy, we provide group therapy, as well as medication-assisted treatment (MAT) when appropriate. Contact us today to start treatment. 

Editor – Nicole LaNeve

Nicole leads a team of passionate, experienced writers, editors and other contributors to create and share accurate, trustworthy information about drug and alcohol addiction, treatment and recovery for The Recovery Village and all Advanced Recovery Systems sites. Read more

Medically Reviewed By – Jenni Jacobsen, LSW

Jenni Jacobsen is a licensed social worker through the Ohio Counselor, Social Worker and Marriage and Family Therapist Board. She has seven years of experience working in the social work field, working with clients with addiction-related and mental health diagnoses. Read more