New Review Examines Psychosocial Treatments for Substance Use Disorder
Effective treatment for substance use disorder (SUD) can include counseling and other psychosocial approaches, such as Cognitive Behavioral Therapy (CBT) and Contingency Management (CM). These therapies can help people build coping skills, manage cravings, strengthen relationships, and work toward their own recovery goals.
A systematic review published in Clinical Psychology & Psychotherapy examined 64 randomized controlled trials published between 2021 and 2025. The studies looked at psychosocial treatments—including CBT, CM, and mindfulness-based approaches—across different substances and treatment formats, such as in-person, digital, and hybrid care.
Across the studies, interventions were associated with improvements in substance use and related outcomes, including craving, confidence in managing use, treatment participation, and social functioning. Results varied by intervention, substance, and study population. The review excluded studies that examined pharmacological treatment alone. In the included studies, psychosocial interventions were sometimes provided on their own and sometimes alongside medication; the review did not compare these approaches directly.
What did the studies find?
Cognitive Behavioral Therapy (CBT): CBT had the most consistent supporting evidence, particularly for alcohol use and tobacco disorder. CBT strategies include coping and problem-solving skills, relapse prevention, and building confidence in managing substance use. The studies linked CBT with reduced drinking, more abstinent days, and improvements in coping, problem-solving, self-efficacy, and social functioning. Programs combining CBT with motivational interviewing or other strategies also showed favorable results, especially for alcohol use.
Contingency Management (CM): CM uses incentives to reinforce treatment goals, such as attending sessions or achieving abstinence. Studies found improvements in treatment participation, retention, and short-term abstinence, especially in studies involving stimulants and cannabis. The authors note benefits could lessen after incentives ended, and recognize the value of pairing incentives with skills-based treatment and continuing support.
Mindfulness and other acceptance-based approaches: These approaches aim to help people respond to cravings, stress, and difficult emotions. Some studies found reductions in heavy drinking or smoking, or improvements in cannabis-related outcomes such as time before returning to use. Other studies found no significant effects on substance use or craving. Results were mixed, and the authors note that these approaches should be tailored to a person’s needs and delivered with appropriate clinical oversight.
Digital and technology-assisted programs: Web-based programs, apps, text messages, and virtual reality were used to deliver treatment and provide support between appointments. Some studies reported improvements in substance use or related outcomes. Their effects appeared to depend on participant engagement and integration with clinical care. The authors describe digital tools as a way to extend access and continuity of care, rather than replace established treatment.
Taken together, these findings highlight psychosocial treatment as an important part of SUD care. CBT programs were the most consistently supported psychosocial options for SUD, particularly in studies focused on alcohol and tobacco use. CM and incentive-based approaches helped improve treatment participation and short-term abstinence in some studies, especially those involving cannabis or stimulant use disorders. Mindfulness-based approaches and digital tools may help address specific needs, particularly when integrated into broader clinical care.
The authors emphasize that treatment plans should reflect each person’s goals and circumstances. They also note that combining psychosocial treatment with medications, when appropriate, may enhance outcomes.
The Article
Mateu-Mollá, J., Mesas-Fernández, J., & Villanueva-Blasco, V. J. (2026). Psychosocial Interventions for Substance Use Disorder: A Systematic Review of Therapeutic Approaches and Their Clinical Effectiveness. Clinical psychology & psychotherapy, 33(2), e70253. https://doi.org/10.1002/cpp.70253
