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Cognitive-Behavioral Therapy in Addiction Treatment

Cognitive-behavioral therapy is one of the most effective methods of helping people overcome substance use disorders.

What Is Cognitive-Behavioral Therapy (CBT)?

Cognitive-behavioral therapy (CBT) is one of the most rigorously researched and evidence-based treatment methods for dealing with varying mental health disorders. While certainly not the only behavioral therapy used in treatment, it is hands down one of the most effective.

CBT is a therapeutic style that emphasizes how cognitive changes can create behavioral and emotional changes. CBT for addiction helps clients change their thought patterns surrounding substance use, allowing them to better handle cravings and find alternative behaviors in which to engage.

The History of CBT

CBT therapy began in the 1960s when it was created by renowned psychologist Aaron Beck. Originally developed as a treatment for depression, the success of CBT led it to be quickly applied to the treatment of anxiety disorders, eating disorders, personality disorders, and addiction as well.[1]

How Common is CBT?

When therapists discuss the gold standard of treatment for psychotherapy, they often bring up CBT, meaning they believe it to be the most effective talk therapy approach to treat a broad range of mental illnesses. As such, it is one of the most common therapy styles in current practice.[2]


Dialectical behavioral therapy is a more recent therapeutic style based on cognitive-behavioral therapy. DBT techniques overlap with CBT but have a few unique twists of their own. Some DBT techniques that are not found in standard CBT include:

  • Mindfulness practices
  • Accepting things as they are
  • Managing emotions, rather than attempting to change them

DBT has been particularly effective at helping treat people with borderline personality disorder but is otherwise very comparable in effectiveness to CBT.[3]

Cognitive-Behavioral Therapy Techniques

Understanding CBT techniques first requires an understanding of a core idea present throughout the therapy. That idea is that thoughts influence feelings and feelings influence behavior, which in turn influences thoughts. This cycle is a core tenet of CBT practices.

Goals of CBT Interventions

This cyclical pattern can keep people feeling, acting, and thinking in a negative way but can also be used to make positive changes in the future. CBT interventions have a few key goals, including: 

  • Identifying negative thought patterns
  • Building new skills to challenge those thought patterns
  • Making meaningful and achievable goals with each client
  • Working on problem-solving in daily life
  • Building the ability to self-monitor thoughts, behaviors, and feelings

A client and a CBT therapy provider can work toward these goals together to help the client build a healthier life.

What Are Cognitive Distortions?

Cognitive distortions refer to specific styles of thinking that lead people to experience or act out on negative feelings and behaviors. There are ten main cognitive distortions:

  • All-or-nothing thinking
  • Catastrophizing
  • Emotional reasoning
  • Fortune-telling
  • Overgeneralization
  • Blaming
  • Disqualifying the positive
  • Filtering out the positive
  • Mind-reading
  • “Shoulds”

These patterns of thinking keep people from achieving recovery and living to their fullest potential.

How CBT Therapy Changes Cognitive Distortions

CBT uses several different techniques to help people overcome cognitive distortions. One of the most common CBT techniques is known as reframing. After a client has identified a negative thought pattern, their therapist may ask them to reframe the thought in a way that doesn’t fall into a cognitive distortion category.

For example, somebody who is employing the “mind-reading” distortion may think to themselves: “They hardly spoke to me all night. They must think that I’m such a jerk.”

One way to reframe this thought could be: “They hardly spoke to anyone all night. I wonder if something is bothering them?” This way of reframing can help minimize symptoms of mental disorders

What Does CBT Therapy Entail?

CBT therapy is hard work and has several goals. Through meeting with your therapist and practicing the techniques you’ve learned in therapy, you will also be working to:

  • Identify challenging conditions
  • Familiarize yourself with your feelings regarding challenges
  • Recognize detrimental thought patterns
  • Replace negative thinking with realistic responses

Remember that the techniques used in CBT therapy sessions take time to sink in. You are learning a new skill that requires practice and dedication to achieve mastery. It’s okay if techniques don’t work right away. 

What Is Cognitive-Behavioral Therapy Used to Treat?

CBT is used to treat a variety of different mental health conditions. Just a few disorders that can benefit from cognitive therapy include:

  • Depression
  • Anxiety disorders
  • ADHD
  • OCD
  • PTSD
  • Eating disorders
  • Sleep disorders

Often, certain conditions require specialized CBT, meaning the techniques are changed somewhat to cater to specific disorders. Trauma-focused CBT interventions are one example. In trauma-focused CBT, extra care is taken to not risk re-traumatization for clients, and certain staple practices of CBT are removed altogether.

The Benefits of CBT for Addiction Treatment

Like so many other mental disorders, addiction has problematic thoughts, behaviors, and feelings that are all intertwined. Addiction therapy using CBT can help people break the destructive thought patterns that keep them returning to substance use. It also teaches them how to explore alternative ways of thinking that facilitate their recovery.

But the best case for using CBT for addiction is that decades of research have shown that it works. Across nearly every type of substance abuse, researchers have found that CBT therapy is effective at helping clients to cut down or stop using altogether. Further still, cognitive therapy can be used to treat clients with co-occurring mental health disorders, who often have a higher risk of relapse if their co-occurring disorder is left untreated.[4]

Other Therapies and Treatments Used Alongside CBT

Of course, the best approach for treating addiction is to use a multifaceted strategy. Not every treatment works for everyone, so it’s often best to provide a wide variety of potential treatment options. Other evidence-based strategies for helping people overcome substance use disorders include:

  • Medication-assisted treatment
  • Motivational interviewing
  • Holistic treatment
  • Peer support groups
  • Relapse prevention programs
Cognitive - Behavioral Therapy

Experience Wellness at Genesis Recovery

Overcoming a substance use disorder is never easy, but it is absolutely possible, provided you get the help you need at a professional addiction treatment center. CBT is a great opportunity to reframe the unhealthy thoughts in your mind.

At Genesis Recovery, we will provide you or your loved one with the best therapists and support systems available, enabling you to regain autonomy over your life and experience wellness.


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