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Addiction Rehab Guide for Couples

Addiction is greedy. It takes everything from the addicted person—health, presence of mind, peace of mind, and, yes, even relationships. Perhaps no one is affected more than the person’s loved ones, including a spouse, life partner, or significant other.

Alcohol and drugs addiction are among the top 10 reasons married couples split up, reports the Couples Counseling Center in Chicago. “In one study, it was reported that as many as 45 percent of couples decide to split because of substance dependence issues,” the center reports.

Clearly, there are serious consequences from abusing substances in an intimate relationship. Because it affects every area of a person’s life, it will inevitably have an effect on anyone who gets close to the addicted person. Because of this, it is even more important to address substance abuse if you truly value your relationship. By clinically tackling the roots of addiction—including the thoughts, emotions, and behaviors that drive it—alongside the loved one most affected by it can go a long way in mending wounds and repairing relationships. 

In this guide, we’ll discover exactly how addiction can infect an otherwise happy relationship as well as how you and your significant other should approach treatment.

How Does Addiction Affect Couples?

Addiction has long been called a family disease, but in past years, treatment for couples and families weren’t offered as widely as individual programs. That is changing. There are treatment centers that recognize the need for couples-based rehabilitation programs for people battling a drug or alcohol addiction. Making the decision to end a substance addiction is no small feat, so getting as much support as possible during a challenging time such as this may prompt someone to seek treatment and open their minds to getting help.

Couples rehab is an option for people in relationships in which one or both partners have a substance addiction and want to get help for themselves and save their relationship. The only way this arrangement can work is if both partners are in it for the long haul and are committed to a life of sobriety. Getting treatment for an addiction is a time and cost commitment, so it helps to be on the same page.

Do You Need Rehab for Couples to Help Stabilize the Relationship? 

Drinking and drug use can derail relationships quickly. In a marriage or long-term union, key areas, such as trust, communication, and intimacy are affected by substance abuse. In unions where one or both people abuse alcohol or drugs, lying is common. There’s lying to one’s spouse or partner to cover up substance use. And, one or both people in the relationship can also lie to cover up substance abuse to people outside of the relationship, such as family and friends.

Misconceptions about the consequences of using drugs and alcohol break up couples and families. Rifts linked to poor or no communication also can destroy relationships. Even if both people are trying to make the relationship work, it can be difficult to stay together under unhealthy circumstances. 

How To Tell if Drinking, Drug Use is Harming The Relationship

Addiction doesn’t take its toll on business and personal relationships overnight. There are sure signs that confirm when the use of drugs and alcohol has become excessive and damaging.

Do you and your spouse or partner:

  • Argue about drinking or drug use or do you argue about matters related to substance use, such as financial problems, staying out too late, not keeping up with household responsibilities?
  • Drink or use drugs regularly to destress and handle tension? Does this cause tension in the home?
  • Cover for the other’s excessive drinking or drug use with excuses and rationalizations? Do you lie for a partner if a supervisor calls to find out why the person missed work?
  • Experience episodes of domestic violence or intimate partner violence when either or both partners have used alcohol or drugs?
  • Show more affection when one or both partners are high or drunk? Do one or more partners feel enabled to approach problems in the relationship when inebriated?
  • Isolate yourselves from loved ones or friends to hide drinking or drug use?

Can Rehab for Couples Help With Addiction Problems?

Yes. Going to couples rehab is an option for those who want to get help for their individual addiction and repair the relationship.

Benefits of Couples Rehab 

Addiction rehab centers can help couples find their center and get back to what’s important in their lives. Recovery from alcohol and drugs can seem like an achievable, realistic goal when two people commit to addressing addiction together, whether it’s one or both partners in the relationship. Couples rehab can bring issues to the forefront and highlight what needs to be worked on.

A main benefit of going to a couples rehab is both partners will have to address multiple factors that contribute to addiction, including:

  • Genetics
  • Biological contributors (such as mental health disorders, poor nutrition, health)
  • Upbringing
  • Environment (work, school, home)
  • Stressful situations
  • Trauma

People who complete couples rehab also will learn how to have a healthy relationship with themselves as well as their significant other. In many cases, couples will have to learn how to set boundaries, be assertive, and maintain themselves and the household.

Couples rehab and therapy also gives the couple a chance to create a vision for the future and seek the support they need for it to happen.

What Happens in Couples Rehab? Is It Different From Standard Rehab?

Couples rehab can treat the same substance addictions that are treated in standard rehab. Alcohol, and drugs such as cocaine, heroin, methamphetamines, and prescription drugs, are among the substances people can get help for in these facilities.

Therapies that typically are a part of traditional rehab are also part of rehab for couples. Among them are 12-step programs and behavioral therapy, among others. In addition to those, relationship counseling is offered to help both parties work toward their mutual recovery goals and develop a foundation to build on once treatment has been completed.

There are different kinds of treatment programs, from outpatient, which offers the most flexibility to inpatient and residential, which require a 24-hour stay at a facility from 28 days or longer. Couples rehab can be one of these or a combination of both. One person can be admitted into inpatient or residential treatment while their partner can attend outpatient sessions.

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Behavioral Couples Therapy (BCT) and Other Approaches

Behavioral couples therapy, also known as behavioral marital therapy, is a family-based treatment approach designed for people who are in relationships and struggling with alcoholism or drug abuse. The couples can be married or living together for at least a year. BCT addresses issues that couples face together as well as how the family is affected by the actions of the person who’s using. The three main objectives of this kind therapy are a) eliminating drinking and drug abuse, b) engaging the addicted person’s family so that the person will change, and c) changing the way the couple and family members act so the new patterns established support long-term, stable abstinence.

BCT helps couples:

  • Address the issues and challenges that are contributing to the alcohol, drug use
  • Focus on improving the relationship and rebuilding trust
  • Establish healthy communication skills
  • Replace problematic behaviors with positive behaviors
  • Reduce the risks of relapse with support for each other
  • Promote abstinence and grow the parts of the relationship that supports that goal

Generally, in this kind of therapy, only one person in the relationship is working through a drug or alcohol problem. The therapy begins when the person in recovery is signing up for outpatient treatment or has finished a medical detox, intensive, short-term drug or alcohol program. Before the non-using partner can join therapy sessions, a therapist must get permission from the person in recovery.

Clients are required to remain abstinent from drugs and alcohol daily, and they are held to this agreement made official with a recovery contract. The contract is verbally agreed to and partners help reinforce it. It serves several purposes. One is to ensure daily progress is made and that the couple is rebuilding trust in the relationship.

According to the contract:

  • The client in recovery agrees not to use alcohol or drugs that day (this action is in alignment with the 12-step philosophy of focusing on sobriety one day at a time)
  • The client in recovery’s spouse agrees to be supportive of the client’s efforts to not drink or use
  • Both partners agree to avoid talking about past alcohol or drug use, and concerns about future substance use. Such talks can end up in a conflict that could be triggering of the person in recovery to use again. Couples can have these talks in therapy. 
  • The non-using partner will witness and verbally support the partner in recovery as the person takes medication daily during recovery period, per the contract. This is to ensure the proper medicines will be taken.

Sessions typically last 60 to 90 minutes and can include group, individual, or couples sessions. There are three treatment phases in this therapy. They are a) orientation, b) primary treatment, and c) discharge.

The orientation phase typically lasts four weeks. During that time, basic medical information and history are collected. Clients also can attend individual or group therapy during this period. In addition to this assessment, how substance use disorder is affecting the relationship is also reviewed. The primary phase of the therapy lasts 12 weeks. In addition to individual or group sessions going on, couples therapy sessions can begin.

The next and last phase is the discharge phase, and clients will attend individual therapy sessions at that time. During the first few weeks of therapy, the focus will be on the substance abuse and any problems stemming from it that thwart stability in the relationship. After that, therapy sessions focus on improving the relationship to support continued sobriety. 

Does Behavioral Couples Therapy Work?

According to the the report Behavioral Couples Therapy for Substance Abuse: Rationale, Methods, and Findings, “In multiple studies with diverse populations, patients who engage in BCT have consistently reported greater reductions in substance use than have patients who receive only individual counseling.” Of course, whether BCT actually works depends on the couple and how much time and effort they put into the therapy.

Integrative Behavioral Couple Therapy (IBCT)

Integrative behavioral couple therapy (IBCT) is described as integrative in at least two ways, according to Andrew Christensen, a clinical psychologist and professor at the University of California, Los Angeles (UCLA) and the late Neil S. Jacobson, who was a clinical psychologist and professor at the University of Washington. It combines the goals of acceptance and change as positive outcomes for the couple in therapy. And, it joins different treatment strategies under a consistent behavioral theoretical framework, the site says.

According to the IBCT site, “The latest research on IBCT suggests that among couples chosen for therapy because they had serious and chronic distress, over two thirds of couples remain together and show significant clinical improvement at the end of therapy as well as two years after the end of therapy.”

Alcohol Behavioral Couples Therapy (ABCT)

Alcohol behavioral couples therapy (also called alcohol-focused behavioral couple therapy) is a structured outpatient treatment program for people who have alcohol use disorders. The model assumes that a person’s drinking has affected the intimate partner involved and that there is a relationship between conflict in the relationship and the person’s drinking.

ABCT teaches couples skills to improve communication, problem-solving, self-control, and others to promote abstinence and sound relationship. It is designed for both partners at least 12 to 20 sessions that are typically run up to 90 minutes each. 

Recovering Couples Anonymous (RCA)

Recovering Couples Anonymous is a 12-step fellowship for couples in recovery from alcohol, drugs, and/or behavioral addictions who want to restore their relationships. According to RCA’s website, the only membership requirement “is the desire to remain committed to each other and to develop new intimacy.”

While the organization is not affiliated with Alcoholics Anonymous, its principles are based on AA’s. RCA promotes working its 12-step program together as a couple. It offers online resources to help any couple that wants to heal their relationship, including materials that address how to use the 12 steps to take a closer look at an issue. Interested couples can look online for meetings that are held in their area.

Dual Diagnosis Addiction Rehab for Couples

Couples in which one person has a mental health disorder and a substance use disorder face unique challenges that are best addressed by rehab that specifically offers treatment for people who have both conditions present and/or occurring at the same time. This condition is known as dual diagnosis. Such centers have medical doctors as well as mental health professionals on staff who can treat physical and mental needs.

LGBTQ+ Couples Rehab

There are drug and alcohol treatment centers that offer programs that address the specific and unique needs of couples in the LGBTQ+ community who are healing from substance abuse and addiction. Many people in this community face challenges that prompt them to turn to alcohol and drugs to deal with stress, rejection, discrimination, harassment and abuse (including intimate partner abuse), violence, and much more. An LGBTQ+-friendly space can connect people in this community to others who can support them and understand their perspective.

The Substance Abuse and Mental Health Administration (SAMHSA) offers facilities guidance on how to treat people in this population. The guidance can inform how treatment centers can best address the needs of LGBTQ+ couples in recovery, and it also is a good place to learn what to look for when reviewing facilities and their programs.

Should Couples Go to Rehab Together?

Sharing the goal of recovering from substance abuse and addiction can help couples keep each other motivated to work toward living sober and avoid relapse. However, there are times when attending rehab together is not ideal. Sometimes people need to deal with their issues on their own. In those cases, each person may want to consider going to rehab separately. The time and space away from each other can be just enough to see the issues and challenges clearly and gain the strength to face and resolve them.

Couples who have a history of violent or aggressive behavior between them also may want to consider going to rehab separately. People who have mental health disorders and require a higher level of care also are candidates for getting treatment apart from their significant other. Clients who are codependent also may face some challenges with getting addiction treatment together. They may find it difficult to detach from thoughts about their partner to focus on their own or they may fear punishment of some kind if they are honest. Fortunately, couples therapy and individual therapy can help build up these skills.

Separate, however, doesn’t always means “not together.” In cases where two addicted people get treatment at different places, they can schedule therapy sessions together where they can work on their challenges together. This may actually make treatment more effective and the results long-lasting.

If only one person is interested in pursuing rehab but the other partner isn’t, couples rehab isn’t going to work. However, the person could consider other kinds of therapy that encourage one to focus on working on their own challenges.

Can Non-Addicted Partners Be Supportive Without Enabling?

When a person cares about a loved one, they will do almost anything to avoid conflict with them or keep the person happy, including looking the other way and letting the person continue doing something that is harmful. Sometimes people look away to allow a person to “hit rock bottom” with their addiction, but that’s a mistake.

There are all sorts of reasons why people ”let things go” with their loved ones. But watching the person deep dive further into addiction is not a way to offer help. In fact, allowing abusive behavior to continue is only making the problem worse. Non-addicted partners who are in relationships with addicted people may be contributing to the problem and either be partially aware of it or not aware of it of it all. When this happens, the addicted person may find it hard to stop using, and the person who isn’t using finds it harder by the day to cope with a heavy situation in which it seems there’s no way out.

According to a Psychology Today article written by Karen Khaleghi, Ph.D., enablers take away motivations for addicts to assume responsibility for their actions when the enablers attempt to “solve” the problem for them. “Without that motivation, there is little reason for the addict to change. Enablers help addicts dig themselves deeper into trouble,” Khaleghi writes.

She reminds us that there is a fine line between helping someone and enabling them. Here are things to consider when determining if one is helping or enabling?

  • Do you often ignore unacceptable behavior?
  • Do you find yourself resenting the responsibilities you take on?
  • Do you consistently put your own needs and desires aside to help someone else?
  • Do you have trouble expressing your own emotions?
  • Do you ever feel fearful that not doing something will cause a blowup, make the person leave you, or even result in violence?
  • Do you ever lie to cover for someone else’s mistakes?
  • Do you consistently assign blame for problems to other people rather than the one who is really responsible?
  • Do you continue to offer help when it is never appreciated or acknowledged?

If you answered yes to any of these questions, it may be time to take a step back and evaluate whether your actions are helping you or your loved one. If an addicted loved one is in rehab for drug treatment, that can be helpful for the person’s spouse or significant other to participate in the recovery process. If the addicted person is not in treatment, the significant other may have to get counseling on their own for issues they are dealing with is. As mentioned earlier, addiction is greedy and affects everyone in the addicted person’s life. No one emerges unscathed from addiction.


Couples Counseling Chicago, (January, 2018).Reasons for Divorce: Top 10 Reasons Marriages End. Couples Counseling Chicago. Retrieved March, 2018 from

American Psychological Association. (2011 January) The couples doctor. DeAngelis, T. Retrieved from

Substance Abuse and Mental Health Administration. Behavioral Health Equity. Lesbian, Gay, Bisexual, and Transgender (LGBT). Retrieved from

verywellmind. (2020, March 25) Counseling Helps Marriages in Trouble With Addiction. Hartney, E., BSc., MA, PhD Retrieved from

McCrady, B, (January, 2017).12 Step Recovery for Couples. Recovering Couples Anonymous. Retrieved March, 2018 from

Psychology Today (2012, July 11) Are You Empowering or Enabling? Khaleghri, K. Ph.D. Retrieved from

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