How Does Cognitive Behavioral Therapy Help with Addiction?

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When thinking of alcoholism or drug abuse, we usually pay attention to the focal point of the addiction. However, substance use disorders have less to do with the substance itself and more to do with our brains.

In principle, addiction of any kind is a disease of the mind, and cognitive behavioral therapy can help treat it effectively.

Although CBT is most commonly used in dealing with anxiety and depression, it has also been demonstrated to effectively help those battling substance abuse issues.

As a matter of fact, did you know people already suffering from mental health issues are more prone to fall victim to addiction? This means that cognitive therapy for addiction can benefit patients in different aspects of their lives and mental health other than their primary reason for seeking out treatment.

Let’s look at all the benefits.

How does Cognitive Behavioral Therapy Work?

Cognitive-behavioral therapy is built on the idea that a person’s thoughts, behaviors, and feelings are all interconnected. Stemming from this suggestion is the belief that these three can be highly influential on one another.

CBT doesn’t seek to find an underlying cause for maladaptive practices but simply works on changing your relationship regarding them. 

A combination of cognitive and behavioral interventions can help patients change the way they conceptualize problems and how they feel about them, as well as rewire unhealthy thought patterns and behaviors.

Addiction treatment benefits from the general structure of CBT but may encompass a wide array of different interventions to emphasize specific targets.

Cognitive Behavioral Therapy and Addiction

The use of psychoactive substances can turn into a problem or even a disorder when it causes substantial distress and debilitation to a person.

Alcohol is most commonly used, perhaps due to ease of access; however, drug abuse and improper medication consumption also affect millions of people yearly.

CBT addresses negative actions and thought processes. When dealing with addiction, patients need to overcome the strong reinforcing effects of psychoactive substances.

Usually, we can observe three distinct phases in CBT to treat addiction. These are functional analysis, cognitive strategy implementation, and the development of deficient skills.

Functional Analysis and Case Conceptualization

A psychoanalyst might probe your childhood, but a cognitive behavioral therapist will ask what usually happens before you take a substance, what are the settings and circumstances surrounding the usage. Basically, in early CBT, the goal is to determine the trigger.

The functional analysis allows for targeting consequences and behaviors by uncovering the contributing factors. To do this, the therapist and client work backward from the negative outcome and break the behavior down into parts.

Later on, based on this work, case conceptualization and altering certain parts in the behavioral chain can lead the client to different, better outcomes.

Cognitive Intervention

When the triggering circumstance has been identified, patients can minimize the probability of encountering such an event again. Furthermore, therapy can help provide alternative responses to triggering cues in case avoidance is impossible.

Encouraging these substitutes to behaviors and decreasing the likelihood of substance use involves the application of motivational and intervention strategies.

This is where cognitive restructuring comes in. New mental processes are consciously implemented to help drive actions.

In CBT for addiction, a patient may need to address issues specific to addiction such as rationalizing behavior and giving up on recovery.


Building up psychological skills is essential to CBT. This phase will target interpersonal and emotion regulation, as well as organizational or problem-solving deficits.

Oftentimes, those suffering from substance misuse disorders will experience difficulty in delaying short-term pleasure in favor of long-term rewards. This goal-setting allows for improvement in critical skills. Sometimes skills that may have been adaptive to the client while in active addiction do not translate well to their desired lifestyle.

For example, interpersonal skills required to obtain a substance, not get caught, and manipulate people, aren’t going to help build healthy activities post-addiction. 

Interpersonal skills training works on repairing relationships, encouraging social support, and effectively communicating.

This helps build a strong support system to fall back on when experiencing difficulties in recovery. Interpersonal skills are also vital in rejecting offers of drugs or alcohol.

Emotion regulations help patients tolerate negative feelings such as distress and aid the development of new strategies to cope. 

In CBT for addiction, patients need to find pleasurable non-use activities to help abstinence, which helps occupy time that would otherwise have been devoted to the addiction.


Cognitive behavioral therapy for addiction is structured and goal-oriented. As such, it’s usually completed within 16 sessions and may be administered in individual or group settings.

CBT has been demonstrated to be effective in dealing with addiction issues and many people have benefited from cognitive and behavioral restructuring. To start CBT, you’ll need to find a licensed professional that can guide you through the process. 

However, the first step is always entirely committing to recovery. Therapy can only help you as much as you allow for it. 

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