The Importance of Cognitive-Behavioral Therapy in Treating Addiction

Garrett Stanford
April 18, 2020

People with substance use disorder have a variety of treatment options available. Whether they choose an inpatient residential treatment program, a partial hospitalization program, or outpatient services, they will likely encounter a combination of multiple treatment modalities that work in tandem to help the patient recover from addiction. Along with 12-step programs, support groups, and medication, counseling remains one of the most reliable methods for treating problems with drugs or alcohol. Therapists can also provide counseling to deal with the challenges that newly sober individuals face as they rebuild their lives. While there are many different kinds of therapy, and many people use a combination of several types, the most effective one for treating addiction is cognitive-behavioral therapy, or CBT.

What is Cognitive-Behavioral Therapy (CBT)?

Cognitive-behavioral therapy is a research based treatment that involves working with a patient to alter disadvantageous behaviors and thought patterns. Unlike psychoanalysis-based counseling, cognitive-behavioral therapy does not involve reflecting on the meanings or unconscious motivations behind behaviors. Rather, this action-oriented therapy focuses on making concrete changes in an individual’s way of life. As such, it usually has a finite duration and is considered complete when specific and clearly articulated goals are met.

Cognitive-Behavioral Therapy (CBT) Techniques

Cognitive-behavioral therapists work with clients to assess and change maladaptive behavior. In a typical CBT session, the counselor will suggest alternative coping strategies to deal with negative thoughts. CBT therapists also often assign homework to their patients so they can begin to practice implementing these alternative behaviors. They also work to change the negative emotions driving the destructive behaviors by identifying what cognitive-behavioral therapists call “cognitive distortions.” Cognitive distortions are patterns of thinking that lead to an irrational and reactive relationship with the outside world. By working to eliminate cognitive distortions, cognitive-behavioral therapy helps people suffering addiction, depression, anxiety, and a host of other disorders approach the world with more freedom and equanimity.

Cognitive distortions as delineated by cognitive-behavioral therapy include:

  • Mind reading: Assuming you can know what is going on in another person’s head, thinking people hate you, etc.
  • Catastrophizing: Believing that something that is happening or will happen will be impossible to handle, that everything is hopeless, etc.
  • Overgeneralizing: Interpreting one negative event to mean that everything is negative.
  • Regret orientation: Rather than focusing on improving behavior in the present, ruminating one how one could have done better in the best.
  • Blaming: Seeing other people as the source of your problems rather than taking personal responsibility.
  • Dichotomous thinking: Viewing yourself, your actions, or the world in all-or-nothing terms. In the case of addicts, this could mean interpreting a craving for drugs or alcohol as an excuse to completely relapse.
  • Shoulds: Imposing upon yourself or the world your feelings about how it ought to be, rather than accepting it and dealing with it as it actually is.
  • Emotional reasoning: Prioritizing ones feelings over the facts and evidence at hand.

These are just a small selection of the cognitive distortions therapists work with clients to eliminate. By changing these thinking patterns and suggesting alternative coping strategies, therapists can help clients ameliorate addictions and handle the interpersonal challenges they face in their newfound sobriety.

CBT Based Treatments for Substance Use Disorder

Cognitive-behavioral therapy is uniquely beneficial for drug addiction treatment. As a research based therapy with specifically articulated goals, it can help individuals with substance use disorder address their thinking and behavior surrounding drugs and alcohol. While CBT is used effectively in rehab centers that follow an abstinence-model, it can also be used as part of a harm reduction plan for individuals who hope to continue drinking but in less destructive ways. This treatment modality is also helpful for dual diagnosis patients who suffer from other mental health disorders in addition to addiction. Developed originally for depression and then later applied to anxiety and other issues, cognitive-behavioral therapy can be adapted to the individual needs of a specific client so that co-occurring mental illnesses do not trigger a relapse. CBT, combined with a sober social support system and the resources of an accredited treatment center, is an essential component of achieving sobriety.

Overcome Addiction with CBT at an Outpatient Treatment Center

Individuals suffering from substance use disorders are generally advised to seek help by enrolling in a formal treatment plan. For people with severe physical dependence on their drug of choice, this process usually begins with a medical detox center, where people can undergo withdrawal under supervision. Afterwards, case workers will likely recommend an inpatient treatment center, intensive outpatient program, or partial hospitalization program. These treatment programs generally include cognitive-behavioral therapy as a cornerstone of their recovery plans. By taking advantage of cognitive-behavioral therapy and other resources, newly sober individuals can begin to change their approach to life and ultimately achieve long term sobriety.

Garrett Stanford
Garrett Stanford brings years of experience working with individuals and families struggling with substance abuse and behavioral health issues. He began working in the nonprofit treatment sector for 2 years before transitioning into the private sector. Garrett has been involved in treatment since 2010, with 10+ years of experience ranging from operations, administration, admissions and addiction research.
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