Couples Addiction Therapy: How It Works

Many people undervalue couples addiction therapy, but they should not because of how severely substance abuse can destroy healthy relationships. 

There is a plethora of information and programs available that focus on individual alcohol and drug addiction treatment and programs.

Couples Addiction Therapy works by focusing on both partners impacted by substance abuse and addiction, rather than an individualistic approach that only addresses one substance user. This therapy generally focuses on addressing the nine major problem areas that contribute to or are affected by substance abuse, which are: 

  • Household Responsibility
  • Rearing of Children
  • Social Activities
  • Money
  • Communication
  • Sex
  • Academic or Occupational Progress
  • Personal Independence
  • Spousal Independence

This kind of therapy is intensive and exhausting for both parties but is an undeniably important step in treating and recovering from substance abuse and addiction. 


What Will Couples Therapy Do For Me?

Besides addressing you or your substance abuse and how it affects your relationship and family, couples addiction therapy will help you transition from a destructive cycle of substance abuse and relationship dysfunction to a constructive cycle of substance recovery and improved relationship function. 

This is done through interventions that address both sets of issues at the same time. This chart demonstrates each cycle and the transition from destructive to constructive, which is discussed below.

A destructive cycle has four elements, which each lead to another. These elements are common in relationships where one or both parties struggle with addiction:  

  • Arguments about past use, nagging, caretaking, etc. 
  • Relationship dysfunction
  • Lack of communication, problem-solving, caring behavior, etc.
  • Substance use and abuse


With the help of counseling and treatment, couples will transition to a constructive cycle, including such elements: 

  • Relationship enhancement
  • Increase in caring behaviors
  • Enhanced relationship function
  • Continuing recovery plan
  • Recovery contract
  • Self-help support
  • Standard substance abuse treatment
  • Substance use recovery
  • Problem-solving skills
  • Communication and skill training


In addition to this, studies have shown that there are three major benefits to engaging in couples therapy, either solely or in addition to individual counseling: 

  • Greater reductions in substance abuse and addiction
  • Higher levels of overall relationship satisfaction
  • More improvements in areas of relationship and family functioning


Types of Couples Therapy

There are a variety of couples and family-based treatments available to partners in all stages of the treatment and recovery process. Specific types of couples therapy and treatments include: 

  • Cognitive Behavioral Couples Therapy – Uses principles of Cognitive Behavioral Therapy (CBT) to improve couples’ interactions and relationship
  • Integrated Behavioral Couples Therapy – Emphasizes the importance of both acceptance and change in a relationship 
  • Emotionally-Focused Couples Therapy – Focuses on emotions as the primary method of therapeutic and cathartic change
  • Group Therapy – Brings together groups of couples to support each other and discuss common or unique relationship challenges


What To Expect From Couples Addiction Therapy

The largest component of this type of therapy and behavioral couples therapy is communication. You’ll be talking to your therapist, partner, friends, and family, and possibly even other couples undergoing treatment. 

You’ll also have exercises and “homework” to complete outside of your therapy sessions. This will be the bulk of your therapy, and it’s you and your partner who will need to put in the work to apply the information you learn from counseling, address your substance abuse, and repair your relationship. 


These are some of the exercises that you can expect to complete or discuss: 

  • Marital Happiness Scale – Rating happiness on a scale of 1 (completely unhappy) to 10 (completely happy) regarding the nine major marital problem areas 
  • Perfect Marriage Procedure – Listing the actions that they believe would create a “perfect” marriage; detailing marital fantasies that are “selfish”
  • Appreciation Reminder Procedure – Reminding or listing recent examples in which a partner did something that the other found rewarding, pleasing, novel, etc.  
  • Shared Rewarding Activities – Planning and taking part in mutually agreed-upon activities that are rewarding and engaging for both parties
  • Practicing Communication Skills – Practicing skills such as active listening, paraphrasing, empathizing, and validating that improve communication
  • Happiness Contracts – Listing activities that each person will start or continue to do will make the other happy and promise to complete them willingly via contract
  • Providing Evidence of Care – Planning a “surprise” in which one party does something to show they care for the other party
  • Fantasy Fulfillment Procedure – Discovering new activities that are satisfying for each individual and which would increase their happiness in the relationship
  • Sex Feedback Procedure – Discussing (directly or indirectly) as many sexual desires as possible to the other individual; listing sexual fantasies that are “selfish”


When Is It Time to Seek Couples Addiction Therapy?

The American Association for Marriage and Family Therapy (AAMFT) discusses substance abuse and intimate relationships in depth. Besides discussing the personal costs and treatment options, it also lists several indicators of when drinking or drug use is harming the relationship, and it’s time to consider seeking professional help. 


It may be time to seek couples therapy if:

  • Most of your communication (or arguments) revolve around one or both partner’s substance abuse
  • You have to consistently “cover” and make excuses for a partner that is indisposed due to substance abuse
  • Substance abuse is necessary before you or your partner can show affection to the other or communicate seriously
  • Your partner abuses substance(s) as a way to cope with stress related to the relationship or family
  • Drinking or using drugs is one of the only activities you enjoy doing with your partner or vice versa
  • You or your partner struggle with physical as well as substance abuse when under the influence
  • You or your family have become isolated from your support system to hide or avoid talking about the substance abuse


If any one of these points sounds a bit too familiar, it may be time to start seeking individual and couples addiction counseling. 


Who Does Couples Addiction Therapy Work For?

In a perfect world, this type of therapy would work for all couples wherein one or both partners suffer from substance abuse and want to address it and repair their relationship. But unfortunately, that’s not the case. There are several indicators of whether or not couples therapy will be effective, discussed below.  


Addiction therapy tends to work best for couples that:

  • Are committed to their relationships and future
  • Are willing to receive and learn new information
  • Have recovery and abstinence as their goal


Addiction therapy doesn’t tend to work for couples wherein:

  • One or both are not committed to recovery
  • One or both are also physically abusive


A contested third bullet point may be “both couples are addicted,” as there is some debate about whether this therapy works best for couples wherein only one person is addicted versus dually addicted couples. 

One study ultimately found that, while possible, “attempting to address the substance abuse of only one partner in a dually addicted couple—the most common circumstance, since both partners rarely seek help at the same time—often creates conflict. ; This may be resolved only through either dissolution of the relationship or continued drug use by the partner being treated.” 


What Comes After Couples Addiction Counseling?

After you complete your couple’s addiction therapy, it’s up to you to continue to receive individual, couples, or family treatment if necessary and begin your recovery process.

According to the Substance Abuse and mental Health Services Administration (SAMHSA), four major elements support recovery: 

  • Health – overcoming or managing your addiction and symptoms and making informed and healthy choices that support your overall well-being
  • Home – having a stable and safe place to live
  • Purpose – participating in meaningful daily activities and society
  • Community – having relationships and social networks that provide support, friendship, love, and hope


The National Institutes on Health (NIH) outlines three major types of recovery programs: 

  • Recovery-Oriented Systems of Care – A chronic care management model for severe substance use disorders that include long-term outpatient care, recovery housing, and recovery couching and management checkups.
  • Recovery Support Services – A collection of community services that provide emotional and practical support, such as mutual aid groups, recovery coaching and management, and recovery-based education.
  • Social and Recreational Recovery Infrastructure and Social Media – Programs that focus on social interaction during recovery and make it easier for people to enjoy activities and social interaction that do not enjoy alcohol or drugs.


For couples, the last type of recovery program may be especially beneficial, as it includes recovery-specific cafes and clubs, sports leagues, and even art programs. Such places provide a safe space for date nights, socializing with friends, and meeting other couples undergoing therapy.


Steps Recovery Centers is Here for You

Substance abuse and addiction is hard on everyone impacted by it, from the user to friends to family members and especially to partners. However, with dedication and hard work, couples addiction therapy can be a valuable first step in addressing your addiction and working to solve the damage it’s caused. Steps Recovery Centers believes in treating residents holistically so that they can overcome their addiction in a healthy manner. We have locations in Salt Lake City, St. George, and Utah County, Utah. Get in touch with us today


Steps Recovery Center realizes the importance of maintaining a safe and effective environment for our clients and staff. As such, we are actively following all Centers for Disease Control (CDC) and the World Health Organization (WHO) Guidelines. The additional measures we take at Steps Recovery Centers include implementing the following protocols: admissions screening and testing, coronavirus infection control plans, providing education to clients and staff, and daily, effective screening of all employees and clients for Coronavirus symptoms. To ensure we protect and promote the health and wellbeing of our staff and clients, we will continue to monitor any developing updates to COVID-19, including exposure statistics in the community and guidelines provided by the Utah Department of Public Health.