How Cognitive Behavioral Therapy Is Used in Addiction Treatment

Cognitive behavioral therapy (CBT) was introduced in the 1970s as an effective treatment for substance abuse disorder and other mental health issues like anxiety and depression. CBT is generally employed on its own or in combination with other treatments and therapies to assist addicted people to achieve long term sobriety. This kind of therapy is delivered either in an individual or group setting and is considered to be highly effective in providing patients with coping skills for relapse prevention.

What Is CBT?

Cognitive behavioral therapy is a combination of behavior therapy and cognitive therapy and is based upon goal setting and achieving by adapting thought processes and behaviors. In other words, it empowers people to set and achieve their own personal goals through more positive choices and actions. Before CBT is commenced, a thorough assessment of the patient is undertaken so that the focus of the program is tailored to their specific needs.

Addiction Treatment

The cognitive behavioral approach is not the same as other therapies that involve discussion or talking although there is naturally an element involved. The difference is that CBT sessions involve skill-learning and building and patients will also be required to carry out some tasks as homework. In this sense, CBT therapists also act as teachers although the learning is entirely focused on the individual in rehab.

Because of the nature of cognitive behavioral therapy programs and the fact they explore deeply personal issues, a strong trust relationship is required between patient and therapist. This working relationship benefits from the patient providing the therapist with feedback throughout the process, enabling them to make any changes to treatment that may be required.

What Role Does It Play in Addiction Treatment?

Many addiction treatment programs include CBT as a means to empower patients with the skills to rely on themselves and their own abilities. Many people with addiction lose their sense of identity and generally also have low self-esteem which can be boosted by the techniques learned in CBT sessions.

When someone has completed CBT treatment, they are able to face the stressors and triggers of daily life without the assistance of a therapist. It has been proven to reduce the likelihood of relapse to allow patients to enjoy a healthier and happier life in sobriety.

How Does It Work?

The initial appointment generally entails the patient being introduced to the concept of CBT. It is always important for patients to have a full understanding of what they are embarking on, as their complete participation is necessary for treatment to be effective. The first discussion between patient and CBT therapist will be focused on the negative behaviors that have surfaced as a result of addiction. Then goals will be set to overcome those behaviors by the patient themselves and an agreement made with the therapist to direct treatment towards achieving them. In this way, a tailored treatment program is devised by both the patient and therapist that address all the issues highlighted in the first appointment.

CBT uses the following strategies in addiction treatment:

Goal Setting

During discussions between the patient and therapist, a list of specific outcomes will have been created and these represent the patient’s goals. It is important that these goals are measurable and also observable so that progress is identifiable. The therapist will ensure that the patient doesn’t set unachievable goals or have overly high expectations which have the potential to lead to relapse.

Agenda Setting

Putting a timeframe to achievements is a good way of motivating patients in addiction treatment. Through collaboration a patient and therapist can determine how much session time should be dedicated to the achievement of a certain goal and then prioritize it. Identifying when progress is made is very beneficial for someone in addiction treatment as it promotes a healthier self-image.


Relaxation is incredibly important as a defense against stress, a major factor in addiction. CBT teaches patients some important techniques for decreasing anxiety and tension and they can be adapted for individual patient’s needs. The techniques learned in CBT sessions can be invaluable as protection against relapse.


One of the biggest effects of addiction is loss of self-confidence and it can often become a barrier to reaching out for treatment. CBT instills more self-acceptance in patients and a better understanding of their abilities and capabilities. Learning how to have control over responses and reactions is essential for someone who has been lost to a negative compulsion such as addiction.

Behavioral Activation

CBT uses a set of strategies that have the effect of influencing someone’s mood and emotions. In the same way that thoughts influence actions, the opposite is also true and behaviors also influence thoughts. CBT focuses on behaviors and a therapist is able to teach patients how they can control their thoughts by adapting the way they behave. For example, if someone is introduced to new and enjoyable activities they spend more time in a positive frame of mind. By pursuing this kind of activity, over time, they can replace negative thoughts and feelings with more positive ones, often finding that cravings for substances are reduced as a consequence.

CBT as Part of Effective Addiction Treatment

There is no isolated approach to addiction treatment center  largely because everyone has varying medical and psychological needs. However, CBT is considered an effective complement to a balanced program because of its efficacy in relapse prevention. The main benefits of rehab are that patients re-learn how to live a healthy and happy life independently and CBT is valuable in teaching the most effective techniques.

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