Individual Therapy

What’s involved in individual therapy for addiction and mental health disorders? Learn about the history, expectations and forms of individual therapy.

When a person decides to see a trained professional to discuss thoughts, behaviors and patterns, the process can result in substantial and positive changes. As the benefits of individual counseling become increasingly apparent and as society begins to embrace mental health treatment, an increasing amount of people are choosing to pursue individual therapy for self-betterment.

What Is Individual Therapy?

Individual therapy is portrayed in movies, on stage, in commercials, on television shows and other media in iconic images of a client on a couch and a therapist sitting close by, writing on a notepad. Though these images may be parts of many people’s perceptions of counseling, exactly what is individual psychotherapy?

In individual psychotherapy, or talk therapy, a mental health treatment professional works with the patient or client on a one-to-one basis, and usually during in-person sessions. Individual psychotherapy is by far the most common type of therapy and is comprised of several different therapeutic approaches.

The primary goal of individual therapy is to increase understanding of one’s thought and behavior patterns to help increase function and well-being. In therapy, people can learn how to effectively manage stress, interpersonal difficulties and troubling situations. They may develop abilities to make healthy decisions, set goals and become more self-aware.

How Psychotherapy Works

So, how does psychotherapy work? Is it similar to how popular culture and the media portray it?

Types of Psychotherapists

In individual psychotherapy, a person seeking help (called the client or patient) meets with a trained and licensed mental health professional (the therapist) regularly. These mental health professionals are often:

• Psychologists
• Licensed clinical social workers
• Marriage and family therapists
• Psychiatrists
• Psychiatric nurse practitioners

Students and trainees working toward these professions can also provide therapy under supervision from a licensed therapist.

The Therapist-Client Relationship

As they meet and discuss the client’s goals, therapists and clients can develop a rapport with each other, a connection that allows them to feel comfortable around each other so that they can talk honestly and freely. The more open and honest the communication is between a therapist and client, the more likely it is that treatment will be effective.

The subjects and topics that get discussed between a therapist and a client depend on the client’s goals and the therapist’s expertise. A client may wish to make significant changes in fundamental personality characteristics, or may wish to focus particular attention on a specific condition or topic. Therapists are often trained in multiple forms of therapy and utilize different approaches for different concerns (or sometimes multiple approaches for one concern).

Therapist-Client Confidentiality

Therapists are professionally bound to act in clients’ interests (called a fiduciary responsibility). They also must preserve the confidentiality of their clients’ identities and the content of what clients discuss with them.

A therapist is legally obligated to break this confidentiality if:

• The therapist believes a client is in immediate danger of self-harm
• The therapist reasonably believes a client may harm someone else
• The client is too disabled to take care of basic needs like food, clothing and safety
• A judge directly orders a therapist’s treatment records

Therapy must establish client safety and professionalism, providing an environment free from offensive behavior, discrimination, sexual misconduct or harassment and financial malfeasance. Therapists often have detailed contracts explicitly stating their responsibilities to you and your responsibilities to them to maintain the client-therapist relationship.

What to Expect

Before beginning treatment, clients and therapists can and should communicate about what to expect from psychotherapy. Doing so helps both parties establish goals that are both reasonable and well understood.

Clients have responsibilities to:

• Develop an idea about what they would like to address in therapy
• Establish a means of finding a therapist (through referral from friends or family, a primary care physician, an employee assistance program or an insurance provider)
• Interview the therapist candidate and inquire about:
  • Background (the therapist’s expertise, experience and education level)
  • Rate structure (fees charged per hour or month, insurance coverage)
  • Treatment frame (goals, length of each session, total length of treatment)
  • Logistics (location of office, access to resources, emergency availability)

The First Psychotherapy Session

During the first session, clients should expect to discuss the reasons they are seeking therapy. The therapist will listen to these concerns and will also need to gather information about your mental and physical health. It may take several sessions for a therapist to get a solid understanding of a client’s needs and how to best help.

Clients may opt to interview multiple therapists and get a sense of who seems to be a good fit for their needs. A therapist may also decline to further treat a client if it does not seem like a good fit or the concerns are outside of the therapist’s expertise. In this case, the therapist is professionally and ethically obligated to provide a referral to another therapist.

Session Structure

In therapy sessions, the client usually does most of the talking, with the therapist providing feedback as necessary or as requested. This practice encourages client self-confidence and keeps the focus of the sessions on the client’s needs. Sessions can provoke many feelings: joy, relief, sadness, anger, shame, guilt and fear, among others. Therapists can help clients make sense of those feelings and help clients utilize their understanding of these feelings to improve their emotional functioning.

Sessions in individual psychotherapy are typically 45-60 minutes in length, generally taking place in a therapist’s office. In a growing number of instances, therapy takes place via video conferencing or through the use of smartphone applications. Such access is often a necessity for clients who live in remote areas, and can be a significant convenience for those who live closer to city centers.

Types of Psychotherapy

Several types of individual psychotherapy have been developed in the last 100 years, each of which has particular characteristics, strengths and benefits.

Among the more commonly utilized types of psychotherapy are:

• Cognitive behavioral therapy (CBT): This is a type of therapy which helps clients understand the connections between their thoughts, beliefs, emotions and actions. Cognitive behavioral therapy empowers clients to change how they feel by changing the way they think.
• Dialectical behavioral therapy (DBT): An offshoot of CBT, dialectical behavioral therapy is designed specifically to help clients with borderline personality disorder, but can be applied in multiple circumstances. The goal of DBT is for the therapist to help the patient in a non-judgmental way, and for the client to experience feelings and emotions in a non-judgmental way.
• Acceptance and commitment therapy (ACT): In ACT, therapists help clients work toward acceptance of their emotions and behaviors rather than avoiding or being in conflict with them. As clients declare their personal value systems, they commit to changing those behaviors that don’t align with their values.
• Psychodynamic therapy: Also called insight-oriented therapy, psychodynamic therapy helps clients understand how their past experiences influence their present ones. It is the oldest form of psychotherapy. This therapy has a goal of identifying a client’s unconscious defense mechanisms. Though psychodynamic therapy accomplishes this goal by encouraging a client to talk about whatever comes to mind, this therapy can be adapted into a more focused form to treat specific problems.

Benefits of Individual Therapy

The benefits of individual therapy can be life-changing, and often last much longer than the therapy itself does. Among the many benefits of individual therapy for the client are:

• Establishment of a trusting, healthy, safe adult relationship
• Ability to articulate feelings and emotions
• Identification of defense mechanisms
• Insight into problematic behavior patterns
• Understanding of appropriate boundaries
• Accountability for behavior
• Increased self-awareness and self-efficacy

How Long Does Individual Therapy Last?

Longitudinally, how long individual therapy lasts depends on the client’s goals, the therapist’s availability, financial factors and other matters.

Some individual therapy that focuses on specific concerns, such as coping with a job loss, may only last a few sessions. Other types of therapy like cognitive behavioral therapy have a prescribed length of time (often 12 to 20 weeks).

Therapy that aims to make fundamental changes in a person’s character makeup, such as psychodynamic therapy, do not have a prescribed length of time, but it can take two years or more to see results. In general, the more fundamental the change being sought, the longer the therapy takes.

Effectiveness of Individual Therapy

Several forms of individual therapy are effective for a host of mental health conditions. The effectiveness of psychotherapy has been well established for conditions like anxiety for decades.

Cognitive behavioral therapy, perhaps the most versatile of the types of therapy, has been shown in clinical trials to be effective in the treatment of:

• Major depressive disorder
• Panic disorder
• Generalized anxiety disorder
• Obsessive-compulsive disorder
• Post-traumatic stress disorder
• Substance use disorders
• Class C personality disorders
• Chronic pain

Psychodynamic psychotherapy was the first type of psychotherapy utilized to effectively treat anxiety. As it has developed and evolved, psychodynamic psychotherapy is just as effective as other talk therapies in the treatment of depression. A form of this therapy called brief psychodynamic therapy is particularly effective in the treatment of addiction.

Goals of Psychotherapy

For clients, goals of individual therapy may differ depending on their needs. However, all therapists aim to achieve the following:

• A strong sense of trust between client and therapist
• Open and honest communication
• Understanding the benefits of the client-therapist relationship
• Utilizing those benefits to understand a client’s established thought and behavior patterns
• Increasing the client’s self-awareness of emotions and typical defense mechanisms
• Fostering a strong internal structure to effectively manage feelings and emotions

Individual Therapy in Addiction and Mental Health Treatment

The power of individual therapy is based on the idea that it is beneficial to be able to articulate feelings without judgment, and that it is healing to be heard and understood. Individual therapy can help build some of the internal structure that wasn’t adequately developed previously.

This restorative ability makes individual therapy an essential component of addiction and mental health treatment. Individual therapy allows a person to be able to recognize typical defense mechanisms, to examine the development and enactment of unhealthy behavior patterns, to recognize the origin of those patterns and to develop the internal tools to find alternatives — skills that are of the utmost use in addictive, mental health and co-occurring conditions.

If you struggle with a drug or alcohol addiction and a co-occurring mental health condition, The Recovery Village can help. The Recovery Village has a network of licensed, experienced and caring therapists who are ready to help you improve your well-being and get the recovery you seek. Call us today to find out more information.

Editor – Camille Renzoni

Cami Renzoni is a creative writer and editor for The Recovery Village. As an advocate for behavioral health, Cami is certified in mental health first aid and encourages people who face substance use disorders to ask for the help they deserve. Read more

Medically Reviewed By – Dr. Kevin Wandler, MD

Kevin Wandler holds multiple positions at Advanced Recovery Systems. In addition to being the founding and chief medical director at Advanced Recovery Systems, he is also the medical director at The Recovery Village Ridgefield and at The Recovery Village Palmer Lake. Read more