Cognitive-behavioral therapy is based on the idea that feelings and behaviors are caused by a person’s thoughts, not external stimuli like people, situations, and events. So, while you may not be able to change your circumstances, you can change how you think about them. According to cognitive-behavioral therapists, this helps you change how you feel and behave.
In The Treatment Of Alcohol And Drug Dependence, CBT Can Help A Person 
- Improve self-control
- Recognize situations in which they are most likely to drink or use drugs
- Avoid trigging circumstances, if possible
- Develop coping strategies that will help when they are faced with situations that trigger cravings
- Cope with other problems and behaviors that may lead to their substance abuse
The primary goals of CBT in the treatment of substance use are to improve motivation, learn new coping skills, change old habits, and learn to manage painful feelings better.
How CBT Works
CBT helps clients learn skills that can be used in the present and interventions that can be applied to the future to reduce stress, improve behaviors, and increase overall well-being. CBT is a frequently used therapeutic style for addiction and mental illness because it works. In addition, CBT has been studied and tested to prove its efficacy and value in several settings and for several presenting problems. CBT will look very different depending on the therapist and the setting.
Your Therapist Will Serve Several Functions During Your Treatment
- Teacher: They will provide education regarding your symptoms, diagnosis, and treatment. (Homework may be given to gather more information away from the session.)
- Teammate: As you work through the process, they will assist with your planned interventions to achieve your goals.
A typical CBT session will last 45 minutes to an hour and involve discussing irrational thoughts, negative behaviors, and stress of the last week. From there, your therapist will challenge your negative thinking and faulty beliefs while offering positive coping skills to employ when faced with challenges.
CBT helps clients learn skills that can be used in the present and interventions that can be applied to the future to reduce stress, improve behaviors, and increase overall well-being.
Types Of CBT
There are several approaches to CBT. This includes:
- Cognitive Therapy
- Dialectic Behavior Therapy
- Rational Behavior Therapy
- Rational Emotive Behavior Therapy (REBT)
- Rational Living Therapy
Other CBT Techniques
Other interventions in CBT include:
- Relaxation training for anxiety
- Assertiveness training to improve relationships
- Self-monitoring education to enhance insight
- Cognitive restructuring to modify thinking patterns
Cognitive Behavioral Therapy For Addiction
Addiction is a clear example of a pattern of behavior that goes against what the person experiencing it wants to do. While people trying to overcome addictive behaviors will often say they want to change those behaviors and may genuinely want to quit alcohol, drugs, or other compulsive behaviors causing them problems, they find it extremely difficult to do so. In the cognitive-behavioral therapy approach, addictive behaviors, such as drinking, drug use, problem gambling, compulsive shopping, video game addiction, food addiction, and other types of excessive harmful behavior, result from inaccurate thoughts and subsequent negative feelings.
Cognitive-behavioral therapy explains this by clarifying the way that people’s thoughts and emotions interact. For example, psychologists realized that many of us have untrue, unrealistic, or impossible to live up to. These thoughts can cause negative feelings that feed anxiety, depression, and conditions such as alcohol and substance use disorders. When used to treat addictions, CBT focuses on systematically recording thoughts, associated feelings, and the events that trigger those thoughts and feelings. This allows us to look at the behavior that we carry out due to those thoughts and emotions. Once this happens, we can begin to change the automatic processes that sabotage our efforts at changing our behaviors.
CBT helps people look at patterns of thoughts and feelings that they repeatedly experience. Then, over time, they can begin to change those thoughts by consciously looking at situations in more realistic ways that do not automatically lead to negative emotions and resulting cycles of harmful behaviors. By rewarding ourselves for the healthier behaviors, we replace those harmful behaviors with, over time, the healthier behaviors become associated with more positive emotions and become more automatic.
CBT has an excellent track record, with numerous studies demonstrating its effectiveness in treating depression, anxiety, and other conditions, including addiction. The CBT approaches that became popularized towards the end of the 20th century are refined and supplemented by the so-called “third wave” of behavior therapy, which focuses on mindfulness, acceptance, and being in the moment. These approaches include acceptance and commitment therapy (ACT), dialectical behavioral therapy (DBT), mindfulness-based cognitive therapy, and functional analytic psychotherapy.
Benefits Of CBT For Addiction
People who have a substance or alcohol use disorder may often struggle with negative feelings or thoughts that make recovery more complex. Because CBT focuses on identifying and replacing such thought patterns with more adaptive ones, it can help improve a person’s outlook and support skills that support long-term recovery.
Some of the ways that CBT can be beneficial for people who have an addiction include:
- Learning to identify self-destructive thoughts and actions
- Finding ways to monitor such thought patterns
- Learning new, more adaptive ways of thinking
- Applying skills that have been learned in new situations and settings
- Exploring new ways to handle stress and difficulties
Research suggests that CBT skills are enduring and can also be applied in other areas of an individual’s life. For example, approximately 60% of people treated with cognitive behavioral therapy for a substance use problem can maintain their recovery for a year.
Which Types Of Drug Addiction Does Cognitive Behavioral Therapy Treat?
While cognitive-behavioral therapy may be used to treat addiction to numerous drugs of abuse, research shows that it’s more effective for certain forms of substance abuse than others. According to the National Institute on Drug Abuse , cognitive behavioral therapy is an evidence-based approach to drug addiction treatment for:
The best treatment outcomes were associated with marijuana. After that, cocaine and opioids saw the best results. However, the smallest effects were witnessed in individuals who had poly-substance, or polydrug, dependence. This means that individuals struggling with addiction to more than one substance may benefit more fully from another form of therapy or a combination of treatments.
Cognitive-behavioral therapy has been shown to produce long-lasting results when used to treat various types of addiction. For instance, the article also cited one study that “reported that 60% of patients in the CBT condition provided clean toxicology screens at 52-week follow-up.”
Role Of Cognitive Behavioral Therapy In Dual Diagnosis Treatment
In addition to substance abuse, cognitive behavioral therapy is a research-based treatment for numerous mental and physical health problems, which frequently occur with addiction. Just as negative thoughts feed addictive behaviors, they also worsen the symptoms of certain mental illnesses. If these mental illnesses aren’t addressed and treated, they can worsen the addiction or trigger relapse. When a person has mental health and substance use disorder, they may need co-occurring disorders treatment.
Mental illness and addiction are often closely connected. In many cases, one causes or aggravates the other. If only one disorder is treated, the other can act as a trigger. For instance, if a person drinks alcohol to numb the sense of hopelessness caused by depression, the untreated depression could cause them to break sobriety and drink again.
Examples of mental health disorders that have shown success when treated with CBT:
- Anxiety Disorders
- Bipolar Disorder
- Eating Disorders (e.g., anorexia, bulimia, and binge-eating disorder)
- Obsessive-compulsive disorders
- Post-Traumatic Stress Disorder (PTSD)
- Sexual Disorders
- Sleep Disorders
Research indicates that the skills individuals learn through cognitive-behavioral approaches remain after the completion of treatment. Therefore, current research focuses on producing even more powerful effects by combining CBT with medications for drug abuse and other types of behavioral therapies. A computer-based CBT system has also been developed and is effective in helping reduce drug use following standard drug abuse treatment .
Further, CBT has been shown to reduce symptoms relating to chronic pain. This can be particularly helpful for people who first began drug abuse as a way to self-treat pain. Unfortunately, opioid painkiller abuse frequently begins this way. For these individuals, alternative forms of pain management are essential parts of building sobriety and a strong recovery. By relieving some measure of these symptoms, the trigger (pain) is reduced, decreasing the temptation for self-medication and drug abuse. Maintaining sobriety is a difficult journey, and while long-term success can be built on therapies such as this, positive outcomes are enhanced by a solid support network, including alumni aftercare services.
Other Supplemental Therapies
Another major benefit of CBT for addiction is integrating aspects of various therapy styles while allowing clients to benefit from other services. For example, many CBT therapists utilize aspects of the following orientations in their sessions:
- Motivational Interviewing: This style of therapy involves a specific method of questioning that is particularly helpful in addiction, and it fits easily with CBT.
- 12-Step Programs: Some differences of opinion exist between programs like AA and NA, but the similarities are enough to make these two interventions work well together. Many clients will attend regular meetings in conjunction with their CBT sessions.
- Medication Management: When you work with a CBT therapist, they might recommend a psychiatric evaluation. You may be prescribed medication to help improve your symptoms. Many studies show that CBT and medication work better together than either alone.
- Holistic Approach: A holistic approach will look at your overall well-being to find ways to improve your physical, emotional, and spiritual health.
Finding Cognitive Behavioral Therapy For Substance Use Disorders
If you are interested in starting cognitive behavioral therapy, you are in luck. Because of its strong reputation for being effective across various issues, mental health professionals trained in CBT are widely available. The chances are high that any outpatient individual, outpatient group, inpatient, residential treatment, or rehabilitation program you would attend will be staffed with competent CBT therapists.
The best news is that CBT is very low-risk. The odds of something harmful happening from attending a CBT session is minimal. Suppose you are unsure whether addiction, depression, anxiety, or other issues negatively impact your life. In that case, a CBT therapist can assess your situation and symptoms to see if you meet the criteria for a mental health diagnosis. CBT therapists work with people looking to achieve more from life and with severe mental health and substance use issues.
At We Level Up specializes in the treatment and recovery of co-occurring disorders. If you are concerned about someone suffering from drug addiction and needs CBT therapy, we are always available to talk and provide additional support and resources. Make this your opportunity to reclaim your life. Call today to speak with one of our treatment specialists. Our counselors know what you are going through and will answer any of your questions.
Your call is private and confidential, and there is never any obligation.
 National Institute on Drug Abuse (NIDA). Cognitive-behavioral therapy (alcohol, marijuana, cocaine, methamphetamine, nicotine). Updated June 1, 2020.
 U.S. National Library of Medicine – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2897895/
 National Institute on Drug Abuse – https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral