The pattern differs between individuals. Some people may recognise an escalating problem relatively quickly, while others may function well in many areas of life despite experiencing significant difficulties privately.

Signs that a behaviour may be becoming problematic can include:

• Repeated unsuccessful attempts to reduce or stop
• Spending increasing amounts of time engaging in, recovering from, or thinking about the behaviour
• Strong urges or cravings
• Continuing despite negative consequences
• Neglecting responsibilities or activities that were previously important
• Concealing or minimising the extent of the behaviour
• Conflict with partners, family members, or friends
• Using substances or behaviours to manage difficult emotions
• Returning to the behaviour during periods of stress
• Taking increasingly significant risks
• Experiencing financial, occupational, interpersonal, or health consequences
• Feeling ashamed, guilty, or distressed afterwards but nevertheless repeating the pattern

For some people, the difficulty may involve alcohol or another substance. For others, the concern may centre on gambling or another repetitive behaviour.

A person does not need to wait until they have reached a crisis or “rock bottom” before seeking psychological help.

At People Psychological Solutions, our clinical psychologists work with individuals experiencing difficulties controlling substance use and other problematic behaviours.

Psychological assessment begins by understanding the pattern rather than judging the behaviour.

Depending on the person’s circumstances, this may involve exploring:

• The frequency, intensity, and context of the behaviour
• Situations or emotions that trigger urges
• What the substance or behaviour provides in the short term
• Consequences for relationships, work, finances, health, or wellbeing
• Previous attempts to reduce or stop
• Patterns of craving and loss of control
• Environmental and interpersonal factors that maintain the behaviour
• Motivation and readiness for change
• Co-occurring psychological difficulties
• Current risks and whether additional medical or specialist care may be required

This helps us develop an individualised understanding of what function the behaviour serves and what keeps the cycle going.

For example, two people may engage in the same problematic behaviour for very different reasons. One may primarily use it to escape anxiety or painful emotions, while another may be strongly influenced by habit, reward, social environments, or access.

Effective intervention therefore needs to address more than simply telling someone to stop.

There are evidence-based psychological treatments for substance-use problems and addictive behaviours.

Depending on the person’s difficulties and treatment goals, our psychologists may draw upon approaches including Cognitive Behavioural Therapy (CBT), Motivational Interviewing (MI), relapse-prevention strategies, and other evidence-based behavioural interventions. Clinical guidelines recommend psychological interventions as important components of treatment for a range of substance-use disorders.

Treatment may involve:

• Understanding triggers and high-risk situations
• Identifying the short-term rewards that maintain the behaviour
• Strengthening motivation for change
• Developing realistic treatment goals
• Learning strategies for managing urges and cravings
• Changing routines and environmental triggers
• Developing alternative ways of managing difficult emotions
• Challenging thoughts that contribute to continued use or behaviour
• Developing problem-solving and coping strategies
• Repairing routines, activities, and relationships disrupted by the problem
• Planning for high-risk situations
• Learning from lapses without allowing them to become a complete return to previous patterns
• Developing a longer-term relapse-prevention plan

Treatment goals are developed collaboratively and take into account the nature and severity of the problem, the person’s circumstances, safety considerations, and their readiness for change.

Not necessarily before you contact us.

People seek psychological help at very different stages of change.

You may already be determined to stop. You may want to reduce a behaviour but feel uncertain about giving it up completely. You may simply be wondering whether something has become a problem.

Ambivalence is common.

Motivational approaches do not depend upon confronting, shaming, or arguing with someone until they agree to change. Instead, therapy can help the person examine the discrepancy between their current behaviour and what matters to them, understand their reasons both for and against change, and develop their own motivation for moving forward.

You therefore do not need to arrive at your first appointment having already decided exactly what you are going to do.

Lapses and relapses is not unusual.

Changing an established pattern is not always a linear process.

Someone may make substantial progress and subsequently return to a substance or behaviour during a particularly difficult situation. This does not necessarily mean that all previous progress has been lost.

Therapy can help identify what contributed to the lapse, what can be learned from it, and what needs to change in the person’s coping strategies or environment.

The longer-term aim is not simply to rely on willpower, but to develop more sustainable ways of responding to triggers, urges, emotions, and high-risk situations.

Some substance-related difficulties require medical assessment and treatment in addition to psychological intervention.

This is particularly important because abruptly stopping certain substances after sustained heavy use can result in medically significant withdrawal. Alcohol withdrawal, for example, can become dangerous in people with significant physiological dependence.

Clinical psychologists do not provide medical detoxification or prescribe medication.

Where there are concerns about physical dependence, significant withdrawal risk, severe substance-use problems, or other medical complications, we may recommend assessment by a psychiatrist, addiction specialist, or other appropriately qualified medical practitioner.

Psychological intervention can then form one component of a broader treatment plan where appropriate.

Problematic substance use and addictive behaviours may occur alongside:

• Depression
• Anxiety
• Trauma-related difficulties
• ADHD
• Relationship difficulties
• Difficulties regulating emotions
• Sleep problems
• Other mental health concerns

Sometimes the addictive behaviour has become one of the person’s primary ways of coping with another psychological difficulty.

Addressing the addictive behaviour without understanding these underlying or co-occurring difficulties may therefore leave an important part of the problem untreated.

Our psychologists consider the broader clinical picture and work with the individual to determine appropriate treatment priorities.