What is individual therapy?
Individual therapy is one-on-one time with a therapist, in a private and confidential setting, focused entirely on you. It is where the personal parts of recovery get worked through: the history behind your substance use, the relationships it has affected, the feelings you have not had a safe place to say out loud, and the goals you want to build toward.
At Skypoint Recovery in Richmond, individual therapy is a core part of treatment. It is also where your plan comes together, because your therapist knows your full picture and helps you connect what you learn in groups to your own life.
What happens in your first individual therapy session?
The first session is mostly about getting to know each other. Your therapist will ask about your substance use, your mental and physical health, your family and living situation, what has helped in the past, and what you want to be different. You do not need to have everything figured out or tell your whole story at once.
You will also go over how confidentiality works, including its few legal limits, such as a serious risk to your safety or someone else’s. And you can ask your own questions: how your therapist works, what sessions will look like, and how you will both know whether it is helping.
What do you work on in ongoing sessions?
After the first few sessions, therapy settles into a working rhythm. A session usually starts with how the past days have gone, then turns to whatever matters most right now. Over time, that often includes:
- Understanding your use: What substances did for you, what they cost you, and what tends to come right before a drink or a drug.
- Tailoring your skills: Taking coping skills from CBT, DBT, and group sessions and fitting them to your actual triggers, schedule, and relationships.
- What sits underneath: Grief, trauma, shame, anxiety, depression, or anger that may have fed your substance use.
- Relationships and repair: Rebuilding trust, setting boundaries, and preparing for difficult conversations with the people close to you.
- Mixed feelings about change: Talking honestly about the part of you that is not sure about recovery, without being judged for it. Therapists often use motivational interviewing here.
- Planning ahead: Updating your relapse prevention plan and preparing for transitions such as stepping down a level of care, going back to work, or moving home.
Which approaches do Skypoint therapists use?
Your therapist draws on evidence-based approaches and chooses among them based on your needs rather than using one method for everyone. These commonly include cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT) skills, motivational interviewing, and relapse prevention. When trauma is part of your story, your plan may include EMDR with a clinician trained in it.
The approach matters, and so does the relationship. Therapy tends to go further when you feel understood and respected, so it is always fair to say what is and is not working for you.
How does individual therapy fit with the rest of your treatment?
In our Partial Hospitalization Program, Intensive Outpatient Program, and Outpatient Program in Richmond, individual sessions sit alongside group therapy. Groups give you skills and connection. Individual sessions give you room for what you may not want to share with a group, and a chance to apply what you are learning to your own situation.
Your therapist also works with the rest of your care team, including case management and, when it is part of your plan, medication-assisted treatment (MAT) or family therapy. How often you meet is set at your assessment and adjusted as your needs change.
Is this the right fit for you?
- People who want a private, confidential space for things they are not ready to share in a group
- Anyone with trauma, grief, or a mental health condition alongside substance use
- People who are unsure about change and want to talk it through without pressure
- Those facing a major transition, such as returning to work or moving home after treatment
- People who want one consistent professional who knows their whole story
Frequently asked questions
How often will I see my therapist?
It depends on your level of care and your needs. People in more intensive programs usually meet with their therapist more often, and sessions may become less frequent as you step down to outpatient care. Your schedule is set at your assessment and revisited as you progress.
What if I find it hard to open up?
That is common, especially early on. You set the pace, and your therapist will not push you to talk about anything before you are ready. Trust often builds over a few sessions, once you see that what you say is met without judgment.
Can I switch therapists if it’s not a good fit?
Yes, it is fine to ask. Fit matters in therapy. Tell your therapist or another member of the team, and we will talk through options with you, which can include working with a different therapist.
Is what I say in individual therapy confidential?
Yes, with a few legal limits that your therapist will explain in your first session, such as a serious risk of harm to yourself or someone else. Substance use treatment records also have strong federal privacy protections. We do not share your information with family, employers, or courts without your written consent, except where the law requires it.