Cognitive Behavioral Therapy

Substance abuse happens when a person doesn’t drink or take drugs properly. This form of substance misuse includes excessive consumption or incorrect use of alcohol, prescription medicine, and other legal and illegal substances. Unfortunately, alcohol abuse and drug abuse can lead to what is called a substance use disorder—otherwise known as drug addiction. There is more than one way to treat substance use disorders. Treatment centers often deploy a wide variety of clinical support through therapeutic interventions. When seeking addiction treatment, cognitive behavioral therapy, also known as CBT, is one method that you may find helpful.

CBT for substance abuse is one of the most common and best-studied forms of psychotherapy. CBT combines both the therapeutic approaches of cognitive therapy and behavioral therapy to promote cognitive restructuring. Working with a CBT therapist, patients with a substance use disorder—or other mental health conditions—are empowered to overcome their maladaptive behavior patterns that result in drug abuse.

Cognitive Behavioral Therapy

How Does Cognitive Behavioral Therapy Work?

Cognitive-behavioral therapy is a type of psychotherapy that helps individuals overcome negative thought patterns that lead to substance use. During treatment, patients with a substance addiction are guided through finding connections between their thoughts, feelings, and emotions and their actions. In addition to addiction, CBT is among the behavioral therapies used to treat mental health conditions. 

Therefore, CBT for substance abuse is often included in addiction treatment plans for those who require dual diagnosis treatment. This type of treatment requires that addiction and any other mental health conditions are treated at the same time. 

A cognitive-behavioral approach is helpful for addicted persons who do not understand why they feel or act a certain way. When included in an addiction recovery plan, this form of therapy ends the need for drug use when negative emotions emerge. Further, CBT consists of two theories: cognitive therapy and behavioral therapy.

The Steps and Benefits of Addiction Treatment CBT

Overcoming substance use disorders is a process and will involve steps. Treating substance with cognitive behavioral therapy typically follows what is called the “ABC model.” This model stands for:

A: activating event

B: beliefs about the event

C: consequences of your behavior

This type of behavioral therapy for substance use disorders hinges on changing the B, or beliefs. This is because negative thoughts can influence maladaptive behavioral patterns. For example, many patients turn to drugs as a result of negative thinking. They may interpret a particular situation as a sign of them being inadequate.

Through engaging in CBT techniques, such patients learn to separate themselves from the A, or activating event, through various coping skills. By failing to internalize things they cannot control, patients are better equipped to focus on positive emotions instead of faulty beliefs. This enables patients to avoid high-risk situations through practicing acceptance of events.

​​Cognitive Behavioral Therapy Techniques 

A benefit of CBT is that you can start making changes right away and use these skills for the rest of your life. You can work with your therapist on the techniques that work for you and your unique situation.

The techniques used in CBT can be applied specifically to treat addiction. Here are some of the common techniques that might be used:


Write down the negative thoughts you might have between therapy sessions and how you replaced them with more positive ones.

It can help to look back and see how your thought patterns have changed over time.

Thought challenges

In this technique, you look at the whole situation and consider it from multiple angles. Instead of assuming your own thoughts are the truth, you challenge yourself to look at the situation objectively.

“A lot of the stories we write are fiction, and we tell ourselves they’re true,” Hornstein says. “Then we react as if they’re happening, and we can stimulate our own anxiety response.”

For example, she says, “If I don’t get high right now, or if I don’t have a beer right now, I will jump out of my skin. The challenge is, is that true? You have to decide which thoughts are real and which ones are things your body and mind are inventing.”

Relaxation techniques

Relaxation techniques can look different for everyone. It might be listening to music, gardening, or taking a bath. These can be helpful when you have a stressor that causes you to have a craving.

Relaxation exercises such as deep breathing can be done anywhere.

Guided Discovery

During sessions, cognitive-behavioral therapists may use guided discovery. If your therapist utilizes this technique they will interview you about your viewpoint. Then, they will ask questions that challenge your viewpoint. This is meant to help you consider different perspectives that you might not have thought of before. By exploring other ways of viewing a situation, cognitive distortions can be more easily avoided.

Cognitive restructuring

You look at your thoughts, such as thinking about the worst-case scenario or either-or thinking, and your therapist helps you reframe those thoughts into something healthier and more productive.

Cognitive Behavioral Therapy for Substance Use Disorders

Cognitive-behavioral interventions are an effective treatment for various types of addictions such as cocaine addiction or for addictions to other drugs. CBT focuses on how thoughts influence a person’s mood, which causes them to make behavioral decisions. This is a highly useful relapse prevention tool for people in addiction treatment.

A patient who is trying to overcome their addictive behaviors will eventually find themselves in difficult situations. Just as anyone experiences, they may, for example, fight with a partner. This activating event can lead to thoughts such as: “I’m not good enough,” or “I’m a terrible partner.” These thoughts are largely unhelpful and lead to a deterioration in mood.

When an individual indulges in these negative thought patterns, they are more likely to try and dull their pain by using drugs. Rather than defaulting to dysfunctional and distorted thinking, CBT techniques allow a patient to perceive the world around them in a more reasonable manner.

How is Cognitive Behavioral Therapy Different from Dialectical Behavior Therapy?

Dialectical behavior therapy (DBT) was initially developed to treat chronically suicidal individuals with borderline personality disorder (BPD). DBT treated other mental illnesses in time, but most people treated with dialectical behavior therapy were diagnosed with BPD.

DBT is rooted in cognitive behavioral therapy, but with one main exception. Dialectical behavior therapy emphasized validation or the acceptance of uncomfortable thoughts, feelings, and behaviors instead of going against them. When a person comes to terms with their troubling thoughts, emotions, or actions, they no longer see that change is impossible. They can collaborate with their therapist on a recovery plan.

The role the therapist plays in DBT is to help the individual find a balance between acceptance and change. New skills are also developed, such as coping methods and mindfulness practices. Like individuals treated with cognitive behavioral therapy, people treated with dialectical behavioral therapy are instructed to practice these new ways of thinking and behaving. A crucial part of successful DBT treatment is the improvement of coping strategies.

Find Solace at Harmony Ridge Today

Harmony Ridge Recovery Center uses a unique approach to treating addictions. We use evidence-based addiction treatment practices and a comprehensive-holistic system that includes therapy like cognitive behavioral therapy. Our recovery center has an experienced team of licensed medical professionals, administrative staff, and management ready to serve you. If you have fallen victim to substance abuse, contact us today.

Our Locations

Begin Your Journey to Healing Here

map map