The most effective psychosocial modalities for treating substance use disorders are cognitive-behavioral interventions, motivational interviewing and motivational enhancement, contingency management, community reinforcement, behavioral couples and family therapies, and 12-step facilitation approaches. The foci of these interventions include substance use behavior, patients’ life contexts, and their social and personal resources. Limited evidence is available for these interventions’ differential effectiveness. Brief interventions are highly effective in the treatment of alcohol use disorders. However, as stand-alone treatments, they are best suited for individuals with mild to moderate alcohol use problems. Therapists who are interpersonally skilled, empathic, and nonconfrontational, and who develop a strong therapeutic alliance, are more effective at helping patients achieve better outcomes.