If cutting back on alcohol on your own isn't working, professional support is available — and reaching for it is a sign of strength, not failure. Options range from self-guided apps like Reframe to cognitive behavioral therapy to FDA-approved medications like naltrexone. The right approach depends on your specific situation, and most people benefit from combining multiple types of support.
I want to say something that took me a long time to believe: needing help doesn't mean you're weak. It doesn't mean your situation is worse than someone else's. It doesn't mean you've failed at the "just drink less" approach. It means you've reached the edge of what you can do alone — which is the most normal thing in the world.
We don't expect people to set their own broken bones or remove their own appendix. We understand that some things require professional skill. Changing your relationship with alcohol — especially when it's tangled up with stress, sleep, anxiety, parenting pressure, and years of neural pathway reinforcement — is one of those things. Sometimes you need someone in your corner who knows more than you do.
This guide walks through the full spectrum of support available, from the lightest touch to the most intensive, so you can find the level that fits where you are right now. Dr. Marcus Webb, a clinical psychologist specializing in women's health and evidence-based alcohol reduction, reviewed this article for accuracy.
Signs You Might Benefit from Extra Support
There's no bright line between "I can handle this myself" and "I need help." But here are some signals worth paying attention to:
- You've tried to change on your own — more than once — and keep returning to the same patterns. This isn't weakness. It suggests that the habit has neurological roots that are stronger than willpower alone can address. As we explain in the anxiety-drinking cycle, alcohol literally rewires your brain's stress response systems. Sometimes you need help rewiring them back.
- You notice physical symptoms when you don't drink. Shakiness, sweating, rapid heart rate, or nausea when you go without alcohol are signs of physiological dependence. If you experience these, please consult a healthcare provider before stopping abruptly — withdrawal can be medically serious and should be managed with professional guidance.
- Alcohol is connected to other issues: anxiety, depression, insomnia, or past trauma. When drinking is entangled with mental health conditions, addressing the alcohol alone often isn't sufficient. A therapist can help you work on the underlying factors simultaneously.
- Your drinking is affecting your relationships or parenting in ways you can see but can't seem to change. When there's a gap between what you know and what you do — when you can articulate exactly why you want to stop but keep pouring anyway — that gap often closes more easily with professional support.
- You're carrying significant shame or secrecy. If you're hiding how much you drink, disposing of bottles secretly, or lying about your consumption, that secrecy can become its own trap. A therapist or coach provides a confidential space to be fully honest — often for the first time.
If any of these resonate, please read on. And if none of them do but you're still curious about what's available — that's a perfectly valid reason to explore support, too. You don't need to be in crisis to benefit from help.
The Spectrum of Support
Support for alcohol use exists on a spectrum from fully self-directed to medically intensive. Most people move along this spectrum, starting lighter and adding resources as needed — though there's no wrong starting point.
Self-Guided Apps and Programs
What they offer: Daily lessons, drink tracking, community forums, and structured programs you can complete at your own pace.
Best for: People who are early in the process, prefer privacy, and want to understand the science behind their drinking patterns before committing to live support.
Reframe is the strongest option here — its 160-day neuroscience curriculum provides genuine education about what alcohol does to your brain, paired with practical tools for managing cravings and building new habits. The parent-specific community groups are a real asset for moms. The Alcohol Experiment offers a free 30-day starting point.
Apps work best as a first step or as a complement to other support. For a detailed comparison of apps and programs, see our honest review.
Online Communities and Peer Support
What they offer: Connection with people going through the same experience. Shared strategies. The profound relief of not being alone in this.
Best for: People who find strength in shared experience and want ongoing, informal support alongside other approaches.
Options include SMART Recovery Online (free evidence-based meetings), The Alcohol Experiment community forum, Reddit's r/stopdrinking (one of the most supportive corners of the internet), and membership communities like Reframe's 24/7 forum. These communities are valuable at every stage — from "I'm thinking about thinking about this" to years into a changed relationship with alcohol.
Alcohol-Specific Coaching
What they offer: One-on-one sessions with a trained coach who specializes in alcohol behavior change. Focus on practical strategies, accountability, and goal-setting.
Best for: People who want personalized guidance but aren't looking for clinical therapy. Coaches are particularly good at helping you build replacement routines, navigate social situations, and stay accountable to your goals.
Coaches differ from therapists in that they're typically certified rather than licensed, and they focus on forward-looking behavior change rather than clinical diagnosis or treatment of underlying conditions. Many programs, including Reframe and Monument, offer coaching as an add-on. Independent alcohol coaches are also available through directories like the International Association of Professional Recovery Coaches.
Therapy: CBT, Motivational Interviewing, and EMDR
What they offer: Licensed professional treatment that can address the psychological roots of drinking, co-occurring conditions (anxiety, depression, trauma), and develop evidence-based strategies for lasting change.
Best for: People whose drinking is connected to mental health conditions, past trauma, or deeply ingrained patterns that haven't responded to self-guided approaches.
Three therapeutic approaches have the strongest evidence for alcohol-related issues:
- Cognitive Behavioral Therapy (CBT): Identifies and restructures the thought patterns that trigger drinking. A meta-analysis by Magill & Ray (Journal of Consulting and Clinical Psychology, 2009) found CBT produces significant, lasting reductions in alcohol consumption. This is the gold standard.
- Motivational Interviewing (MI): A collaborative approach designed for people who are ambivalent about change. Rather than telling you what to do, an MI therapist helps you explore your own values and motivations. Research by Lundahl et al. (Clinical Psychology Review, 2010) confirmed its effectiveness across substance use contexts. This works well if you're not sure what you want yet.
- EMDR (Eye Movement Desensitization and Reprocessing): If past trauma — childhood experiences, loss, abuse — is a factor in your drinking, EMDR can help process those memories so they lose their emotional charge. The WHO recognizes EMDR as effective for trauma, and many clinicians report that resolving underlying trauma significantly reduces the drive to self-medicate with alcohol.
To find a therapist, start with Psychology Today's directory (filter by "substance use" and "women's issues"), ask your insurance provider for in-network referrals, or explore telehealth platforms like Monument that specialize in alcohol-related therapy.
Medication-Assisted Approaches
What they offer: FDA-approved medications that reduce cravings, block alcohol's pleasurable effects, or stabilize brain chemistry during early abstinence.
Best for: People who have tried behavioral approaches alone and found them insufficient, or who want to combine medication with therapy for a faster, more supported change.
Two medications have the strongest evidence:
- Naltrexone: Available as a daily pill or monthly injection (Vivitrol). It blocks the opioid receptors that produce the "buzz" from alcohol, making drinking less rewarding neurologically. A comprehensive meta-analysis by Jonas et al. (JAMA, 2014) found naltrexone reduces heavy drinking days by approximately 25% compared to placebo. Some people use it with "The Sinclair Method" — taking naltrexone one hour before drinking, which gradually deconditions the brain's reward response.
- Acamprosate (Campral): Helps stabilize the GABA/glutamate neurotransmitter balance disrupted by chronic alcohol use, reducing cravings and the discomfort of early abstinence. Most effective for maintaining abstinence after you've already stopped.
These medications are available through your primary care physician, psychiatrist, or telehealth services like Monument. They're underutilized — partly due to stigma and partly due to lack of awareness. Dr. Webb notes: "Medication-assisted treatment for alcohol use is one of the most evidence-supported yet least-prescribed interventions in medicine. There's no more shame in using naltrexone than in using an antidepressant."
Intensive Programs
What they offer: Structured, immersive treatment for situations that require more support than outpatient therapy can provide.
Best for: People who are experiencing significant physical dependence, co-occurring psychiatric conditions, or who need a safe, supervised environment to begin the process of change.
Intensive options include: Intensive Outpatient Programs (IOP) — typically 3-4 sessions per week for several weeks, allowing you to live at home; Partial Hospitalization Programs (PHP) — more structured, often full-day programs; and Residential Treatment — live-in programs for the highest level of care. If you're experiencing physical withdrawal symptoms, medical supervision is essential — alcohol withdrawal can be dangerous, and detox should never be attempted alone.
If you think you might need intensive support, call SAMHSA's National Helpline: 1-800-662-4357 (free, confidential, 24/7).
How to Find the Right Fit
A few practical guidelines:
- Start where you are. If you're "just curious," an app or book might be perfect. If you've been trying for months, it might be time for therapy. There's no minimum qualification for any level of support.
- Layer your support. Most people do best with a combination: an app for daily structure, a book for understanding, a therapist for deeper work, a community for connection. These aren't competing approaches — they're complementary.
- Don't quit on finding the right therapist. If the first therapist doesn't click, try another. The therapeutic relationship matters as much as the modality. Dr. Webb notes: "Fit matters enormously. A good therapeutic alliance is one of the strongest predictors of positive outcomes."
- Be honest about what's not working. If self-guided approaches haven't changed your pattern after 3-4 genuine attempts, that's information — not failure. It means the next level of support is what you need.
- Consider the connection between alcohol and everything else. If you're drinking because of anxiety, treating only the drinking leaves the anxiety intact. A good therapist addresses the whole picture.
I Needed Help Too
I want to end this article with honesty. I used Reframe for daily structure. I read five books. I tried breathing exercises and NA drinks and journal dumps. All of those things helped. But what helped the most was three months of weekly therapy with a psychologist who specialized in women's health and habit change.
My therapist helped me see that the nightly wine wasn't just a habit — it was my only strategy for managing the anxiety and overstimulation that come with raising three kids while running a household while trying to maintain a sense of self. She didn't tell me to stop drinking. She helped me build other strategies for the needs that drinking was meeting. Once those strategies were in place, the wine became optional in a way it hadn't been before.
I resisted therapy for months because I thought it was "for people who really have a problem." I was wrong. It was for me — someone with a comfortable life and a loving family and a wine habit that was quietly making all of it worse. Getting help was the smartest, bravest thing I did in this whole process.
If you're considering it, consider this your permission. You deserve support. It's available. And it works.
For a comparison of self-guided apps and programs, see our honest review. If you're new to rethinking your relationship with alcohol, start here.
