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.

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. The co-occurring disorders CBT can treat include the following:

  • Bipolar disorder
  • Anxiety disorders
  • Obsessive-Compulsive Disorder (OCD)
  • Post-Traumatic Stress Disorder (PTSD)
  • Eating disorders

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.

Identify difficult conditions in your life.

These types of situations can range from grief and divorce to a medical condition or mental illness. Have a discussion with your therapist to set goals and pinpoint essential needs.

Be aware of your emotions, thoughts, and behaviors about these conditions.

Once you have identified the life situations you want to focus on, your mental health professional will ask you how you feel about them. This discussion may dive into how you interpret situations and the beliefs you have about yourself and others. You may also evaluate your own “self-talk,” what you tell yourself about an event or occurrence.

Recognize inaccurate or negative thoughts and beliefs.

Your counselor will ask you to observe your behavior and ways of thinking about the previously identified situations, helping you identify problematic thought patterns. Your therapist will then help you change these negative thoughts and beliefs.

Some find this step to be the most difficult one because you might have been thinking the same way about things for a long time. You will have to identify your behavioral and thought patterns, and then your counselor will question whether these views are based on fact or an incorrect perception. This crucial step takes practice, but more helpful ways of thinking will come naturally to you over time.

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CBT 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.

Cognitive Behavioral Therapy

Addiction Treatment Cognitive Behavioral Therapy Techniques

CBT for substance abuse generally includes various types of techniques and behavioral strategies. The skills gained in this type of cognitive therapy are effective in producing positive changes and can be used for the rest of your life. Working with a therapist that specializes in clinical psychology, you will learn the following coping skills and techniques:


Writing down how you feel is a useful tool when you are trying to change your thought patterns. Journaling can provide you with insight into your unhealthy patterns of thinking. Additionally, after you receive treatment, you may also want to look back at how your thinking has changed over time. Witnessing your old thought patterns and comparing them to your new ways of thinking can show you how far you have come.

Relaxation Techniques

During a CBT session, you will likely learn relaxation techniques. This type of skills training helps patients in recovery by providing alternatives to drugs when they feel stressed. These techniques can include the following:

  • Drawing or painting
  • Deep breathing
  • Listening to music
  • Exercising
  • Gardening
  • Taking a bath

Relaxation techniques are different for everyone. The main goal is that what you do replaces addictive behaviors. What one person finds relaxing may not work for another person. Therefore, it is important that you utilize techniques that work best for your needs.

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.

How is CBT 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.

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How Does CBT Help Women?

When it comes to substance abuse, women face unique issues due to sex and gender. There are differences based on biology and culturally defined roles for men and women. Scientific studies on drug abuse discovered that women who use drugs could have issues related to hormones, menstrual cycle, fertility, pregnancy, breastfeeding, and menopause. Women also tend to have different reasons for taking drugs. This includes attempts to control weight, manage pain, and exhaustion, and try to self-medicate mental health problems.

Data support the use of selective serotonin and serotonin-norepinephrine reuptake inhibitors (SSRIs and SNRIs) to treat premenstrual dysphoric disorder (PMDD) that affects some women. Many women choose not to take this route for a condition that occurs once a month. Side effects from such medications such as sexual dysfunction are not appealing. Cognitive-behavioral therapy is helpful to women in treating such premenstrual symptoms because it offers an effective alternative. This alternate method is also used to treat women for substance abuse.

Science has also discovered that women’s substance abuse differs from men’s because they often take smaller amounts of certain drugs for less time before becoming addicted. Sex hormones can cause women to be more sensitive to the effects of drugs compared to men. Females also respond differently to substances. They can experience more drug cravings and can be more likely to relapse after treatment. Women are more likely to be taken to the emergency room from the effects of substance abuse or overdose and are more likely to die. Females that are victims of domestic violence are at a higher risk of substance abuse.

Getting the Most Out of CBT for Substance Abuse

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There are different forms of therapy when seeking treatment for a multitude of conditions like substance abuse.  Like any other treatment form, cognitive behavioral therapy should not be seen as a guaranteed cure for everyone. It’s up to the person to get the most out of their therapy treatments to recover successfully.

Treat therapy as a partnership.
You must be an active participant and a part of the decision-making in treatment. It is essential to agree with your therapist about your significant issues and how to confront them. In this partnership, you and your mental health professional can set goals and evaluate progress over time.
Be open and honest.
Having success in therapy means you have to be willing to share your thoughts, feelings, and experiences and be open to new ways of doing things. Let your therapist know of any reservations you may have about certain things because of painful emotions, embarrassment, or fears about how you think they will react.
Stick to the treatment plan.
It can be tempting sometimes to skip therapy sessions when you start to feel down or lose motivation, which can hurt your progress. Make a point to attend all sessions and think about what you would like to discuss.
Don’t expect results to be instant.
Therapy can be hard work because it involves working on your emotional issues. Don’t get discouraged if you feel worse initially because it is common to feel that way. It can take several sessions before you see improvement.
Do homework between sessions.
Follow through with any homework that your therapist assigns you to do in between sessions. These assignments can range from writing in a journal to doing other activities. Completing your assigned tasks will help you to apply what you learned during their therapy sessions.
Talk to your therapist if it’s not working.
If you feel that your therapy sessions are not working, make sure to discuss this with your therapist. The two of you can decide to make changes or try a completely different approach. If you are battling substance abuse, you should seek treatment. Recovering from a substance use disorder starts the minute you pick up the phone and ask for help. There are many resources, treatment options, and treatment centers available to you.

Find Solace at Harmony Ridge Today

Harmony Ridge Recovery Center uses a unique approach to treat 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.

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