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Medically Reviewed

How is Cognitive Behavioral Therapy (CBT) Used in Addiction Treatment?

- 9 sections

Medically Verified: November 15, 2022

Medical Reviewer:

Sahil Talwar, PA-C, MBA


All of the information on this page has been reviewed and verified by a certified addiction professional.

One of the most effective forms of therapy used in addiction treatment is cognitive behavioral therapy (CBT). This type of therapy is a form of talk therapy that focuses on the principles of behaviorism and the theories of cognition. CBT looks at how behaviors are controlled or modified and focuses on how you think, feel, and view yourself and the world around you.

Cognitive behavioral therapy is effective in treating a wide range of mental health conditions including mood disorders, anxiety disorders, and substance use disorders. Regarding addiction recovery. CBT can help you change negative thought patterns into positive ones and teach you healthy coping skills.

What is Cognitive Behavioral Therapy (CBT)?

Cognitive behavioral therapy was developed in the 1960s by Dr. Aaron Beck.[1] Beck created this type of therapy when he began viewing anxiety and depression as cognitive disorders rather than mood disorders. His theory is that negative patterns of thought are what create negative moods, instead of the other way around.

If your automatic interpretation of a situation is viewed through a negative lens, your mood will be negatively impacted. Cognitive distortions can cause you to overgeneralize, catastrophize, or personalize situations, leading to misguided conclusions about a specific event, situation, or person. As a result, cognition can worsen the symptoms of your mental health condition, whether it be depression, anxiety, or addiction.

Cognitive behavioral therapy focuses on how your thoughts can influence your mood. This therapeutic technique is goal-oriented and works to address dysfunctional automatic thoughts, maladaptive thinking, and underlying core beliefs. While participating in CBT, your therapist will customize the therapy to your specific needs.

Common mental health conditions CBT treats include:

  • Depression
  • Anxiety
  • Bipolar disorder
  • Schizophrenia
  • Substance use disorders
  • Eating disorders

How Does CBT Work?

Cognitive behavioral therapy outlines how your harmful thoughts and emotions are not always logical or rational. Instead, these thoughts and feelings often stem from past experiences or trauma, causing you to have a negative outlook on other aspects of your life or current situation.

If you struggle with addiction, understanding why you think or feel a certain way and how that can cause substance abuse can make you better equipped to achieve recovery.

CBT helps you identify your negative automatic thoughts. Automatic thoughts are based on impulse that often stems from misconceptions and internalized feelings based on fear. When you struggle with addiction, you tend to self-medicate these automatic thoughts by using drugs or alcohol.

When you can identify these thoughts and realize them for what they are, you can begin implementing healthy coping mechanisms to replace drugs and alcohol. This teaches you how to maintain long-term sobriety and avoid relapses in the future by treating the cause of your substance abuse.

Cognitive Behavioral Therapy Techniques in Addiction Treatment

Cognitive behavioral therapy involves specific exercises that directly benefit the addiction recovery process. From learning how to manage triggers to understanding how to practice self-care, these exercises can provide you with a roadmap to navigating life as a sober person.

Examples of CBT exercises used in addiction treatment include:[2]

Thought Records

CBT teaches you how to examine your automatic thoughts while looking for objective evidence that either supports or disproves them. This works by listing the evidence that supports or disproves your thoughts and comparing them, almost like a pros and cons list. The goal of this exercise is to teach you that more often than not, your negative thoughts are not based in fact.

Skills for Managing Triggers

Triggers are situations that cause you to crave drugs or alcohol. Oftentimes, triggers are what prevent people from maintaining long-term sobriety. CBT helps you learn how to manage triggers in three easy steps.

The first step is to recognize the triggers that cause you to abuse drugs or alcohol. Then, you will learn to remove yourself from the situation that is triggering you when appropriate. The last step involves using CBT techniques and coping mechanisms that address and alleviate the emotions and thoughts that led you to want to abuse substances.

Behavioral Experiments

Behavioral experiments compare your negative thoughts against positive ones to see which is more effective in changing your behavior. While one person may respond better to self-criticism, you may experience positive behavior changes using self-kindness. This process helps you determine whether being hard on yourself or using affirmations will help you overcome challenges and instill positive behavior changes.

Imagery Based Exposure

Imagery-based exposure exercises ask you to think of a memory that produces negative feelings. While imagining these memories, you will write down every aspect of that moment, including what you see, hear, feel, smell, and think. Over time, you will begin to experience lessened negative reactions to your traumatic memories because of repeated exposure.

Pleasant Activity Schedule

Lastly, CBT therapists will help you create a pleasant activity schedule. You may make a weekly list of fun and positive activities that you can engage in between your daily schedule, providing you with a break. This helps you learn how to practice self-care and find relaxation between your daily responsibilities, preventing you from becoming overly stressed and experiencing cravings to abuse substances.

Get Connected With a Cognitive Behavioral Therapy-Based Addiction Treatment Program

If you or a loved one suffer from alcoholism or drug addiction, effective treatment programs are available. Getting sober can seem like an insurmountable task, especially when you consider how prevalent relapse triggers are.

Learn more about how cognitive behavioral therapy can help you recover from a substance use disorder by contacting South Carolina Addiction Treatment Center today.