Talking treatments

Man using talking treatments for heroin use

Treatment based on one-to-one or group sessions with a trained therapist to look at key issues. Talking treatments are not often directive (ie they don’t tell you what to do) but they can help you reach an understanding about your own circumstances and make decisions about your future.

People who want to address past traumas, underlying psychological problems or problematic behaviour that may contribute to their drug use and opioid dependence.


  • Having a space to explore difficult issues that is confidential and non-judgmental.
  • Opportunity to address psychological causes of drug use and relapse.


  • Focus on inner conflicts, which can be difficult.
  • Long-term commitment to treatment.
Most community drug services and rehabs will provide access to talking treatments as part of a holistic care plan. You may also access treatment through your GP, a mental health professional or through a charity.

Some people choose to access talking treatments through the private sector, paying on a sessional basis for counselling or psychotherapy. It is important to check the credentials of any therapist you choose to see privately – and to make sure they have some understanding of drug dependency issues. The British Association of Counselling and Psychotherapy and the United Kingdom Council for Psychotherapy both hold a register of qualified therapists. They will be able to help you find a qualified practitioner in your area. If you need help or advice about this, please contact a support organisation.

The therapist or counsellor and you will identify the particular issues for you and will work with you to address some of them including:

  • Problems and concerns that date from before your drug use and may have made the decision to use drugs easier.
  • Problems you experience trying to gain control of your dependence – for example looking at triggers (things that make you want to use drugs).
  • Tackling problems to do with relationships with family and significant others.
  • Overcoming barriers you may experience during your recovery – planning for your future and a life where you control your drug use.

Your therapist or counsellor may use one specific approach or a number of different approaches in combination. Some of the most popular talking treatments include:

Motivational Interviewing – a form of counselling that helps you motivate yourself to improve your life by making goals, plans and changes to your behaviour.

Cognitive Behavioural therapy – an approach which sets out to change the way you think about your problems and so behave in different ways.

Psychotherapy – usually a long-term treatment exploring unexpressed emotions in depth. You are unlikely to be able to access this support through drugs services without a diagnosis of a mental health problem such as severe anxiety or depression.

Psychodynamic therapy – aims to address your reasons for drug use by exploring your past and present situation and helping you understand how past events can affect the decisions you make today.

Long-term benefits
Talking treatment is a critical part of treatment for drug dependency for many people and is included in many treatment programmes in community and residential settings. A lot of people have had difficult experiences or have underlying problems, which they feel led them into having difficulties with drugs in the first place. Working some of these out and learning to live with yourself are important parts of your recovery.

Tips for Success
Give counselling a decent go – some people may find their first couple of sessions uncomfortable – after all it can be hard to open up to a stranger. As you get to know your counsellor and trust that the process is confidential and safe you will start to feel more benefits from it.