How Does Cognitive Behavioral Therapy Help with Addiction?

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how does CBT help with addiction

When thinking of mental disorders, 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 disorders and depression, it has also been demonstrated to effectively help those battling substance abuse issues.

How Cognitive Behavioral Therapy Differs From Other Psychotherapies

Cognitive Behavioral Therapy (CBT) stands out from other psychotherapies due to its focus on identifying and challenging negative thought patterns and behaviors that contribute to psychological distress. Unlike some traditional therapies that delve extensively into past experiences, CBT emphasizes the present and equips individuals with practical strategies to manage and change their responses to stressors. Its evidence-based approach, structured sessions, and goal-oriented nature make it distinct from cognitive behavioral therapies, promoting more rapid and measurable improvements in various mental health conditions.

CBT also treats co-occurring disorders such as:

  • Anxiety
  • Attention Deficit Disorder (ADD)
  • Bipolar Disorder
  • Obsessive Compulsive Disorder (OCD)
  • Eating Disorders
  • Post-Traumatic Stress Disorder (PTSD)

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 their mental health disorders other than their primary reason for seeking out treatment.

Let’s look at all the benefits.

cognitive behavioral therapy

How does Cognitive Behavioral Therapy Work?

CBT operates on these core principles:

  1. Psychological disorders often arise from distorted thinking patterns.
  2. Negative behaviors learned over time contribute to psychological issues.
  3. Individuals can acquire healthier coping strategies to alleviate symptoms and foster positive life changes.

Additionally, therapists may employ role-playing techniques to prepare clients for handling challenging situations in the future. For instance, creating a pros and cons list for various reactions aids in understanding the impact of thoughts and actions. It’s essential to practice such scenarios in therapy, ensuring clients feel prepared and self-assured.

CBT, delivered by a trained therapist, empowers individuals to take charge of their thoughts and develop healthier thinking, emotions, and behaviors. Collaboratively, therapist and client design strategies to identify, challenge, and change negative thought patterns and behaviors, focusing on the present to facilitate improvements. It’s a solution-focused therapy, prioritizing the present and practical steps for enhancing well-being.

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 drug and alcohol abuse 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 treating mental disorders along with addiction, patients need to overcome the strong reinforcing effects of psychoactive substances.

Usually in clinical psychology, 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 cognitive behavioral interventions and 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 the substance use disorder 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 cognitive behavioral treatment for addiction, a patient may need to address issues specific to addiction such as rationalizing behavior and giving up on recovery.


Building up psychological coping 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 a substance abuse treatment or 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 (CBT) Techniques in Addiction Recovery

Cognitive behavioral therapists employ cognitive behavioral approaches and specific exercises to aid individuals in their journey to recovery from addiction. Some examples of CBT techniques utilized in addiction treatment include:

  1. Thought Records:Individuals in treatment assess their automatic negative thoughts, seeking objective evidence to support or refute these thoughts. They compile evidence both in favor of and against their automatic thoughts to conduct a critical evaluation. The objective is to encourage more balanced and less harsh thinking patterns by examining their beliefs.Example: “My manager believes I’m worthless, so I need alcohol to cope” transforms into “Mistakes are a part of life, and I can learn from them. My manager values my ability to learn and grow from my errors. I don’t require alcohol to improve my self-esteem.”
  2. Behavioral Experiments:These exercises involve contrasting negative thoughts with positive ones to determine which approach is more effective in altering behavior. People may respond differently to self-compassion and self-criticism, and behavioral experiments help identify what works best for each individual.Example: “Being hard on myself after binge drinking will reduce future binge drinking” versus “Being kind to myself after binge drinking will reduce future binge drinking.”
  3. Imagery-Based Exposure:During this exercise, individuals in recovery recall a memory that triggers intense negative emotions. They meticulously document every detail, including sights, sounds, emotions, thoughts, and impulses experienced during that moment. Repeated exposure to distressing memories can, over time, diminish the anxiety associated with them.Example: A young man focuses on a distressing childhood memory, vividly recalling every aspect and emotion associated with it. Through repeated exposure, the memory gradually loses its emotional intensity, reducing the inclination to self-medicate with substances.
  4. Pleasant Activity Schedule:This technique involves creating a weekly list of enjoyable, healthy activities to break the monotony of daily routines. These activities should be simple, easy to engage in, and promote positive emotions. Implementing a schedule of pleasant activities can help alleviate negative automatic thoughts and the subsequent urge to turn to drugs or alcohol.Example: Instead of resorting to substance use during work hours, an overburdened financial advisor sets aside 15 minutes daily to unwind at his desk. During this time, he discovers and enjoys music from new artists, fostering a positive and healthy break in his routine.

Goals of CBT

CBT aims to achieve several critical objectives, including:

  1. Identifying Distorted Thinking Patterns: CBT helps individuals recognize and acknowledge their detrimental thought patterns, which are contributing to life challenges. It encourages a reassessment of these thoughts in the context of reality.
  2. Enhancing Understanding: This therapy fosters a deeper understanding of both self-motivation and the behavior of oneself and others. It also equips individuals with practical problem-solving techniques to address life’s challenges effectively.
  3. Boosting Confidence: By developing awareness, understanding, and problem-solving skills, CBT seeks to increase a person’s self-confidence in their ability to manage stressful situations.
  4. Managing Emotions and Facing Fears: CBT empowers individuals to calm their minds and bodies, gradually confronting their fears rather than avoiding them. It serves as a tool to demonstrate that emotions and various life situations can be managed in a healthier manner.


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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