What You Need to Know About CBT for Addiction Treatment

Cognitive behavioral therapy (CBT) is a goal-oriented form of psychotherapy that focuses on solving immediate concerns and helping people with substance use disorders develop the skills they need to stay sober. It’s much less intensive than other forms of psychotherapy, which means it can typically be completed as part of a 30-, 45-, or 90-day drug and alcohol rehab program.

What CBT Can Do

When used as part of a substance abuse treatment program, CBT can:

Help you identify and avoid situations that put you at a high risk of relapse
Teach you ways to cope with cravings
Show you the positive and negative consequences of continued substance abuse
Offer tools to manage painful feelings without drugs or alcohol
Empower you to be proactive in managing your recovery efforts

For people with a dual diagnosis, CBT can also be used to treat co-occurring mental health conditions such as depression, anxiety, or PTSD. It is appropriate for people of all ages, including teenagers and older adults.

Uncovering Cognitive Distortions

The premise behind cognitive behavioral therapy is that we often do not realize when our thought patterns are destructive or causing harm. We get stuck in the same patterns we learned as children or young adults, even when these patterns result in negative consequences.

For example, people with substance use disorders often engage in the following destructive thought patterns or cognitive distortions:

Focusing on negative or upsetting circumstances and ignoring evidence of the positive factors surrounding a specific situation
Always imagining the worst-case scenario when they are faced with a challenge
Believing they know what will happen in the future instead of realizing that none of us are fortune-tellers
Jumping to conclusions with no supporting evidence
Seeing problems in black and white
Assuming they know how other people think or feel instead of making an effort to communicate honestly and openly

CBT helps “break the cycle” by giving individuals the tools they need to better understand the relationship between thoughts, feelings, and actions.

How CBT Works

In a residential treatment program, cognitive behavioral therapy is often used in both group and individual therapy sessions. Group sessions let participants learn from the experiences of others, while individual sessions allow participants to explore specific issues in greater detail. Homework may also be assigned to promote a better understanding of how to apply CBT to everyday life challenges.

There are two main components of CBT: functional analysis and skills training.

In functional analysis, you work to discover the circumstances that led to the development of your addiction. For example, you might discuss how trouble in relationships with family or friends led to you use alcohol as a temporary escape.
In skills training, you develop healthier ways to cope with the issues that led to the addiction. For example, if you’re using alcohol to escape relationship problems, you might discuss healthy ways to communicate your needs and resolve conflict.

Note that in CBT, the therapist is equal parts teacher and teammate. Instead of giving you one-size-fits-all answers, the therapist works with you to develop a plan to reach your personal recovery goals.

Subsets of CBT

In psychology, cognitive behavioral therapy is an umbrella term used to describe several different types of therapies. Subsets of CBT include:

Behavior therapy (BT)
Cognitive therapy (CT)
Dialectical behavior therapy (DBT)
Multimodal therapy (MMT)
Rational emotive behavior therapy (REBT)

Each of these therapies explores the relationship between thoughts, feelings, and actions, but the approaches recommended differ slightly. For example, REBT uses the ABC model: A – something happens, B – you have a belief about the situation, C – you have an emotional reaction to your belief. REBT is also the basis of the popular SMART Recovery self-help program.

Using CBT as Part of a Complete Addiction Treatment Program

Cognitive behavioral therapy has been proven to be successful in helping people build the foundation for a lasting recovery, but it’s not a magic cure or a guaranteed fix for your problems. Addiction is considered a chronic illness that requires a full continuum of care. For best results, CBT should be used with 12-Step support, medication-assisted treatment, holistic treatments, and other therapies recommended by your care team.

At St. Joseph Institute for Addiction’s Pennsylvania drug and alcohol treatment center, we develop personalized care plans designed to fit each client’s unique needs. Our clinical team takes into account factors such as past trauma, previous relapse, and the presence of co-occurring mental health disorders before making treatment recommendations. Contact our admissions office to learn more.