Psychotherapy and patient needs in the treatment of alcohol and cocaine abuse.

The effectiveness of psychotherapy in the treatment of substance abuse continues to be debated among theorists and practitioners. This paper proposes that psychotherapy can play an important role in the treatment of the addictions. However, it is critical that this psychotherapy is geared toward the special needs of substance abusers. Using research on the process of change as a guide, a psychotherapeutic approach for substance abusers is described that responds to the needs of the individual as they shift during the different phases of recovery. Contemporary adaptations of psychodynamic psychotherapy are recommended, along with the appropriate cognitive-behavioral and self-help approaches. In addition, the different clinical considerations for alcohol versus cocaine abusers are examined as they evolve during the change process.