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Cognitive behavioral therapy, or CBT, is a form of psychotherapy used to help people identify negative thoughts, cope with challenging situations, and create managed responses that are both healthy and effective. The Substance Abuse and Mental Health Services Administration reports that alcohol is the most commonly abused substance in America, with nearly 18 million people either dependent or chronically abusing the substance. For decades, doctors, therapists, and researchers have searched for effective ways of rehabilitating individuals who struggle with addiction – not only for immediate detoxification purposes, but also for long-term sobriety. During cognitive behavioral therapy, participants work directly with a therapist to achieve a specific set of goals.
By recognizing the source of unconstructive thoughts, therapists then work with clients to proactively modify unhealthy behaviors.
Cognitive behavioral therapy is a useful tool indicated for the treatment of mental health and behavioral disorders.
A dual diagnosis of mental illness and substance abuse often requires a more complex treatment plan than either condition would require alone.
The theory behind cognitive behavioral therapy is that actions are a product of feelings, which are shaped by thoughts and beliefs.
When a therapist helps identify errors in thinking, clients often notice how thought processes have contributed to negative behaviors and habits. For example, a client may report feeling like a ‘failure’ because he or she was unable to overcome substance abuse for many years.
CBT is usually a short-term therapy that the Substance Abuse and Mental Health Services Administration reports lasts an average of 16 sessions. Cognitive behavioral therapy always begins with an initial session that lays the foundation for treatment.
Because CBT is a goal-based therapy it is normal for therapists to give assignments to be completed between sessions. Over the following weeks, clients are encouraged to open up about their thoughts and feelings regarding personal substance abuse.
For example, CBT may reveal an individual is abusing drugs or alcohol to cope with feelings of inadequacy or helplessness.
Cognitive behavioral therapy is often successful, but long-term results depend on a participant’s willingness and ability to apply learned skills to everyday life. Therapists often adapt sessions to the individual, rather than establishing a cookie-cutter syllabus for treatment.
The exact approach to cognitive behavioral therapy will depend on the client’s specific circumstances and preferences.
The correct mode of treatment is essential to achieving and maintaining long-term recovery from drug or alcohol abuse.
Several types of prevention strategies can be incorporated into a client’s cognitive behavioral therapy in an effort to prevent relapse.
Psychoeducation is a foundational component of therapy for mental and behavioral disorders, such as substance use disorder. Psychoeducation provides educational information about substance abuse and the consequences it generates. For example, cognitive reappraisal can help a person who feels inadequate and hopeless to reinterpret those feelings and his or her own circumstances from a worldwide viewpoint. For example, a recovering alcoholic who is traveling out of town can anticipate the possibility of relapse when away from his or her support system at home. CBT therapists may work to improve client outcomes by addressing the role of triggers in substance use disorders.
Cognitive behavioral therapy has become increasingly more present in drug and alcohol rehabilitation programs due to its long-term benefits and history of producing positive results among individuals who have abused drugs or alcohol. Research has supported the use of CBT for achieving lasting results among people with a history of substance abuse or dependency. The National Institutes of Health report cognitive behavioral therapy to be effective for treating substance use disorders when used as both a mono-therapy and in combination with other treatment strategies. Cognitive behavioral therapy – though an effective means of treating substance abuse – is most effective when used as part of a more comprehensive treatment and rehabilitation program. Despite the effectiveness of CBT for many individuals, sometimes psychotherapy is not enough to help a person maintain sobriety. For example, the National Alliance on Mental Illness reports that many CBT patients supplement one-on-one therapy with participation in a self-help group, such as Narcotics Anonymous or Alcoholics Anonymous. In some cases, patients benefit from prescribed medications intended to aid in maintaining sobriety.
The choice to use substances to manage substance abuse addictions and dependencies is one that must be made between the patient and his or her doctor.
The choice to begin treatment for alcohol or drug abuse is an important step toward sobriety that many people never take. Individuals ready to pursue cognitive behavioral therapy should first find a reputable therapist trained and experienced in substance abuse-related CBT.
Cognitive behavioral therapy is only effective when clients genuinely desire sobriety and are committed to the process. Completing cognitive behavioral therapy will not ‘cure’ substance abuse or cause troublesome situations to go away.
Recovery from alcohol and drug abuse is a journey that is different for every individual that pursues it. Please contact The Delray Recovery Center at (888) 738-9197 for more information about our CBT services.
When people talk about depression, they usually mean a person who is feeling down and lethargic, and who has generally lost interest in life.
While this isn’t an exhaustive list, here is a quick overview of the most common forms of depression. Cognitive Behavioral Therapy (CBT) first emerged as a therapy for the treatment of drug and alcohol addiction in the 1960s, and has been improved upon in the decades since. Cognitive behavioral therapy works in the treatment of drug addiction by helping an individual recognize and address key negative thoughts and subsequent behaviors that fuel their drug addiction. Cognitive behavioral therapy works in phases, first assessing the addiction and any mental health disorders, then working with an individual to re conceptualize their environment. People often behave toward a situation based on feelings and perceptions of their situation.
At this stage, an individual will be taught improved coping skills to replace former drug use, whenever stressful situations or drug triggers arise, and how to apply these skills. There are many benefits to choosing cognitive behavioral therapy to treat drug addiction, including the length and overall impact of the program.
Studies indicate CBT is an effective treatment form, and when used in conjunction with other complementary therapies, including pharmacological, residential, and even the 12-step model, reduces relapse rates considerably. Cognitive behavioral therapy has been shown to be particularly effective for women, who tend to benefit more from empowerment models, than the traditional 12-step program. Though drug cravings can appear to come out of nowhere and can vary with intensity, they usually relate to specific triggers, including locations, people, scents, sights, or reminders of past traumas.
Cognitive behavioral therapy is particularly beneficial in addressing drug addiction in that it focuses on promoting positive action, where an individual before relied on a substance as a coping mechanism.


Multiple studies have shown CBT to be an effective therapy in treating substance use disorder with a co-occurring mental disorder including anxiety and schizophrenia.
One such study examining the effects of CBT on substance use disorder and depression, as a co-occurring mental disorder, found positive results even six months past the last session. Although CBT can be used to address nearly any emotionally demanding circumstance, therapists often find success using it among individuals who suffer from addiction. According to the Substance Abuse and Mental Health Services Administration’s National Survey on Drug Use and Health, more than 22 million people suffered with substance abuse or dependency in 2010 alone. Marijuana is the next most frequently abused substance, followed by pain-relieving prescription medications. Though there is no single method or treatment capable of assisting all people with drug dependencies and addictions, behavior therapy has been shown to be beneficial for helping participants maintain sobriety long after therapy is complete.
Beck identified correlations between his patients’ thought processes and emotions, noticing that most patients’ thoughts were directly influenced by their personal beliefs or attitudes. Beck’s techniques were eventually combined with behavioral therapies, creating ‘cognitive behavioral therapy’. Instead, it is a form of psychotherapy, or psychological counseling, which is specifically structured for short-term use.
Those goals are determined based on an initial session, during which the therapist gathers information about the types of situations or challenges troubling a client.
The goal is to help clients see their substance abuse with greater clarity and generate new, positive responses to those situations. The National Alliance on Mental Illness (NAMI) reports that people with mental illnesses are more likely to develop substance use disorders than people without mental illness.
NAMI states many reasons why a person could develop simultaneous disorders; for example, a person suffering with an untreated mental disorder like anxiety or depression may use substances to self-medicate.
Cognitive behavioral therapy can still be a helpful tool in addressing substance abuse tendencies and preventing recovering substance abusers from returning to a cycle of negative thoughts and behaviors.
For an individual who is abusing a substance, there are often inaccurate beliefs related to drug or alcohol use that produce automatic responses. The goal of CBT is to help them modify those thoughts to encourage honest communication, manage cravings, and produce new, rational responses. Despite the desire to change that behavior, theories of personal shortcomings and self-blame sabotage attempts at sobriety. These sessions can be performed in a variety of settings, from one-on-one meetings to group sessions with other people who struggle with substance abuse. During this first visit, therapists collect information about clients, including their habits, struggles, and ultimate goals for treatment.
These assignments, which may include reading or completing specific tasks, are designed to facilitate treatment and simplify the application of CBT-learned skills in everyday life. Every visit is an effort to pinpoint thoughts and beliefs that could be based on perception or fact. By developing positive thought patterns, day-to-day life feels less overwhelming and there is a weakened desire to turn to substances in an effort to manage negative feelings.
In order to maximize outcomes, therapists adapt sessions to fit the needs of their clients.
A client may benefit from spending multiple sessions reviewing a single concept, whereas other concepts of therapy are personally easy to grasp and require very little attention. This may mean that a client initially meets with a therapist multiple times per week, gradually tapering off to once a week, once a month, or once every few months as recovery progresses.
The number and duration of sessions may be contingent on the severity of a person’s substance abuse, as well as how long it has been a problem.
According to the National Institute on Drug Abuse, people who have achieved sobriety from drug addiction have relapse rates of 40 – 60 percent.
Psychoeducation can be administered on a one-on-one basis or in a group setting with family and friends or other rehabilitating substance users. It can play an important role in helping clients develop a desire for recovery, as well as help them learn about potential obstacles during rehabilitation. Conversely, this technique can also be used to help a perpetual substance abuser reinterpret the positive feelings associated with drug use into negative ones. Despite adopting positive thoughts in place of negative ones, clients must still learn new ways of avoiding or reacting to tempting situations. Skills training teaches clients to take proactive steps in advance, such as having a friend call to check in every few hours or requesting that the hotel staff remove all alcohol from the in-room mini-bar prior to arrival. Success is often contingent on one’s ability to solve circumstantial problems when necessary. According to the National Institute on Drug Abuse, the skills participants acquire in CBT-based therapies and approaches linger long after the treatment is completed. For example, in 2002, researchers at the University of California in Los Angeles published a study that followed patients with cocaine dependencies who underwent various psychosocial and medical treatments to maintain sobriety, including cognitive behavioral therapy. However, it is important to remember that substance abuse recovery is a journey that involves many facets, of which cognitive behavioral therapy is just one. It is often combined with other therapies, such as group therapy or an inpatient treatment program, in order to achieve better outcomes. In 2010 alone, more than 6 percent of the population over age 12 admitted to binge drinking – that equates to approximately 16 million people in the United States. In these cases, cognitive behavioral therapy may be combined with support groups or certain medications designed to aid in substance abuse recovery. In 2011, for instance, only 2.3 million of the more than 21 million Americans who needed treatment for a problem related to drugs or alcohol actually sought treatment from a drug and alcohol abuse facility.
Clients often find new therapists by asking for references from their doctors or by searching the database of their state’s psychological association.
It can, however, improve client perspective and increase confidence in one’s ability to cope with circumstances using positive behaviors rather than destructive ones. Throughout the course of the sessions, CBT helps reveal behavioral patterns that are unique to each individual. There is no finality, and every person needs to be committed to their success in order to maintain sobriety. Most people don’t realize that there are many different types of depression a person can be suffering from, with each type often showing different symptoms. Usually the symptoms aren’t so severe that they have a major impact in the life of the sufferer, although the depression can still cause distress and disruption. Like mild depression, most sufferers never seek help as they don’t believe their symptoms are severe enough. Today, nearly half of all Americans will experience mental illness at some point in their lives, and mental health problems affect more than one-quarter of the population in any given year (Kessler et al., 2005). Cognitive behavioral therapy recognizes that the treatment of addiction doesn’t relate specifically to the thoughts or feelings we have, but our actions in coping with those thoughts or feelings. Re conceptualization raises the awareness that not all thoughts and feelings are based on truths and that assessing which thoughts or feelings are based on reality and which are based on fears or past traumas can help a person reassess their surroundings toward more positive reactions and behaviors. In general, CBT lasts between 12 and 16 weeks, with weekly sessions, leaving time available for complimentary treatment options, work, and school.


One such study examined the outcomes of CBT used in conjunction with naltrexone therapy to reduce opioid dependency and found that participants who received CBT in conjunction with naltrexone benefited from a long-term success rate of 62 percent compared to 40 percent in the non-CBT control group. And because cognitive behavioral therapy is used to treat many of the co-occurring mental disorders that often accompany or precipitate addiction, it is an effective tool in dealing with both the mental and substance use disorder. In addressing perception and helping the individual regain some awareness and control over those external, and even internal triggers, cognitive behavioral therapy can help reduce the frequency or intensity of drug cravings. Once a person is able to identify negative thought patterns or interactions in their lives that created greater vulnerability to drug use, they can then begin to recognize, for example, that when they get a drug craving, it is not likely to last more than 10 minutes. These positive outcomes were increased with the complimentary use of motivational interviewing (MI), and, in some cases, pharmacological therapies. Similar studies on co-occurring schizophrenia and substance use disorder indicate significant improvements for long-term outcome where CBT is incorporated as part of a treatment plan.
Frequent abuse of addictive substances can lead to both physical and psychological dependencies. Aaron Beck – who later co-founded the non-profit Beck Institute for Cognitive Behavioral Therapy – was the first to develop CBT during his time at the University of Pennsylvania. Today’s CBT methods are both problem-centered and action-based – this means that they are used to address specific problems like substance abuse and teach clients strategies for managing those problems. According to the Mayo Clinic, the average person undergoing CBT counseling will require no more than 10 to 20 sessions.
In cases of substance abuse, therapists use CBT to identify negative thought patterns that could be contributing to excessive alcohol or drug use.
NAMI cites scientific research suggesting that one in three people with mental illness is also abusing substances.
However, substance abuse can also originate from the development of a new mental illness, such as paranoia.
Cognitive behavioral therapy works to dismantle critical thoughts, leading to self-propelled change. Negative thoughts produced by an opinion can be invalidated, reducing their power to produce negative reactions. Other factors that contribute to the length of psychotherapy include a client’s personal stress, treatment progress, and whether he or she has the support of friends and family. That is comparable to the relapse rates of several major diseases, such as asthma, hypertension, and Type I Diabetes. Substance abuse psychoeducation often involves the use of a specific curriculum, with the therapist acting as the educator. By altering one’s perspective of a situation, a recovering substance abuser can exchange negative feelings for positive ones, which can ultimately lead to better decision making. CBT therapists may help clients develop specific actions and responses to be carried out sequentially when potentially problematic situations arise.
Therapists may ask clients to imagine themselves refusing a substance they once habitually accepted.
Exactly one year later, 60 percent of the CBT group had clean toxicology screening results. According to The National Institute on Alcohol Abuse and Alcoholism, people with drinking-related disorders achieve better outcomes when cognitive behavioral therapy is used as a part of a more comprehensive treatment program rather than as the sole mode of treatment.
More than 8 in 10 of these individuals who did not seek treatment failed to get help because they did not perceive a need for treatment. Relapses can be prevented by seeking help at the first signs of patterned behavior, and recovering individuals can begin to experience daily accomplishments and victories. Also like mild depression, the symptoms of dysthymic depression don’t usually have a huge impact on the sufferers day-to-day life. Jade WuBoston UniversityIn the past century, a number of psychotherapeutic orientations have gained popularity for treating mental illnesses.
It is a powerful and effective tool in the treatment of drug addiction and shows particular promise in the treatment of women battling addiction. It asks the individual to address their surroundings and any negative thought patterns or feelings associated with their surroundings, and work on viewing this environment from a place of heightened awareness. Cognitive behavioral therapy is also relatively inexpensive and covered by most insurances.
They can then make a conscious choice in that 10 minutes to constructively act and go out for a walk, find a quiet spot and practice mindful meditation, or journal their feelings, in place of turning to their drug of choice.
These studies also point to the cost advantage of including CBT in drug addiction treatment. Contact us today and discover a comprehensive drug treatment plan suited to your needs and preferences and discover a new and rewarding life in recovery beginning today. However, only a patient and his or her therapist can determine how many sessions will be required to achieve desirable results.
Conversely, the same percentage of people who abuse alcohol and as much as 50 percent of people who abuse drugs are also suffering with mental illness.
By visualizing a new response, recovering substance abusers may feel more confident in their ability to overcome negative behaviors on a daily basis. This module outlines some of the best-known therapeutic approaches and explains the history, techniques, advantages, and disadvantages associated with each. This module provides an overview of some of the best-known schools of thought in psychotherapy. CBT is an approach to treating mental illness that involves work with a therapist as well as homework assignments between sessions. Cognitive behavioral therapy seeks to identify thought patterns or behaviors related to unhealthy perceptions, and replace those unwanted behaviors (including drug use) with positive coping strategies or actions. Planning for a healthy coping strategy to replace one that has a damaging effect on the brain and body, is one way to prevent further damage from relapse. Beck believed that patients could alter their thoughts and behaviors by learning to identify invalidated thinking and ‘all-or-nothing’ thought processes. We also discuss psychoanalytic therapy, person-centered therapy, and mindfulness-based approaches.
Randomized controlled assessment of non-directive psychotherapy versus routine general-practitioner care. An outpatient program in behavioral medicine for chronic pain patients\nbased on the practice of mindfulness meditation: Theoretical considerations and preliminary results. Lifetime prevalence and age of onset distribution of DSM-IV disorders in the National Comorbidity Survey Replication. She is a member of the Phi Beta Kappa Society and graduated with honors from Brown University. He is the 2013-2014 president of ABCT, the 2014 president of the IACP, the editor-in-chief of Cognitive Therapy and Research, and the Associate Editor of Journal of Consulting and Clinical Psychology.Q. She is a member of the Association for Behavioral and Cognitive Therapies, and the recipient of several prestigious awards, including the Boston University Dean’s Fellowship and the Clara Mayo Research Award.Creative Commons LicenseTherapeutic Orientations by Hannah Boettcher, Stefan G. Jade Wu is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.



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