Frequently used in drug and alcohol addiction treatment programs, cognitive behavioral therapy (CBT) is a common form of psychotherapy, or talk therapy. It is used to help individuals with substance use disorders become aware of their negative or inaccurate thinking. They are then able to view stressful or challenging situations more clearly and respond to them in a more effective way.
What Is Cognitive Behavioral Therapy?
Pioneered in the 1960s by Dr. Aaron T. Beck, CBT was developed as a way to prevent people with an addiction to alcohol from having a relapse. Later, it was adapted to use with individuals with an addiction to drugs. It is also commonly used to treat many types of mental health disorders including depression, anxiety, phobias, and post-traumatic stress disorder (PTSD).
Cognitive behavioral therapy is a combination of the principles of two therapeutic approaches: cognitive therapy and behavioral therapy. Throughout the treatment program, the therapist helps the recovering addict identify their automatic negative thoughts. These thoughts are usually based on an immediate reaction or impulse stemming from internalized feelings and misconceptions of fear and self-doubt. It is often these painful feelings and thoughts that cause a person to abuse drugs or alcohol.
How Does Cognitive Behavioral Therapy Help?
Cognitive behavioral therapy can quickly help a person identify and cope with the specific challenges they are facing. It generally is carried out in a structured way and requires fewer sessions than many other types of therapy.
CBT is useful in addressing emotional challenges such as learning various techniques for dealing with stressful life situations, preventing a relapse of symptoms of mental illness, or coping with loss or grief. Additional challenges that can be helped by CBT include:
- Overcoming an emotional trauma caused by violence or abuse
- Treating a mental illness when medications are not an option
- Learning better ways to communicate
- Resolving relationship conflicts
- Learning ways to manage emotions
- Coping with a medical illness
- Managing chronic pain and physical symptoms
What Happens in Cognitive Behavioral Therapy?
Functional analysis and skills training are the two main components of cognitive behavioral therapy.
Functional analysis is when a person is discovering and learning about the circumstances that led to their mental health condition. This detailed look at the past is not intended to shame or judge. The goal is to help the person find a way to move forward.
Once the reasons for the addiction are clear, skills training begins. The individual learns and develops healthy ways to cope with the issues that caused their drug or alcohol addiction. Examples of these techniques and skills could include relaxation, resilience, stress management, coping, and assertiveness.
You will do the following things in cognitive behavioral therapy when you are in an addiction recovery treatment program:
- Consider the positive and negative consequences of continuing to use drugs or alcohol
- Learn self-monitoring strategies to identify cravings before they occur
- Develop ways to cope with cravings
- Learn to identify your negative thoughts
- Put together a plan to avoid high-risk situations
- Identify situations that could trigger a relapse
What Should I Expect During My First Session of CBT?
During the first cognitive behavior therapy session, the therapist will gather information and ask you what you would like to work on. Typically, the therapist will ask about your current and past emotional and physical health to get a better understanding of the situation. The therapist may ask questions about other types of treatments or medications tried in the past or explain how certain types of therapies may be beneficial.
It is important to make sure that you feel comfortable with the therapist and that you are a good match. Make sure that you understand the approach the therapist uses and determine what the best type of therapy is for you.
It is also important to find out the goals of your treatment, the length of time of each session, and how many sessions you may need. It may take a few sessions for your therapist to fully understand your concerns, assess the situation, and determine the best program for you.
During your CBT sessions, you will be encouraged to talk about your feelings, thoughts, and what is troubling to you. This type of therapy usually focuses on a specific problem and uses a goal-oriented approach.
The following four steps are typically included in CBT:
- Identifying situations or conditions that are troubling in your life such as medical conditions, grief, anger, divorce, or symptoms of a mental health disorder
- Becoming aware of your emotions, thoughts, and beliefs about these problems
- Identifying inaccurate or negative thinking regarding the problems
- Learning how to reshape inaccurate or negative thinking
How Is CBT Used as Part of an Overall Treatment Program?
Although cognitive behavioral therapy is an effective resource for reaching the goal of a life of sobriety, overcoming a substance abuse addiction often takes many resources. To be most effective, CBT needs to be part of an overall program that includes traditional and holistic therapies, medication-assisted treatment, and 12-Step support.