How Effective Is CBT for Substance Abuse Recovery?

Cognitive behavioral therapy or CBT is one of the most popular substance abuse treatment methods in use because it can empower clients to do this: confront and dismantle the core beliefs that drive addiction.

CBT, which is a form of talk therapy, equips clients with the tools to cope with addictions and disorders in a healthy manner. CBT can ultimately help them feel better about themselves and their life, according to the Mayo Clinic.

In essence, CBT argues that while you may not be able to change your circumstances, you can change how you think about them.

This is why CBT is employed to treat clients who grapple with anxiety, depression, phobias, and other mental health issues. It is also why it has proven to be effective when it is used to treat drug and alcohol addiction.

In reputable professional treatment settings, CBT is an integral part of the program. Read on to learn more about this evidence-based treatment method and how it specifically tackles substance abuse.

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The History of CBT

Psychiatrist Aaron T. Beck invented cognitive behavioral therapy in the 1960s.

While conducting therapy sessions, Beck would notice that his clients were having an internal dialogue buzzing in their heads. According to PsychCentral, the following is an example of what a client could be thinking during a therapy session:  

“He (the therapist) hasn’t said much today. I wonder if he’s annoyed with me?” A thought like this could provoke a client to think he is unworthy of attention or care — a notion that could substantiate a negative core belief.

But that client could respond to that initial thought with an assessment that is more realistic:

“He’s probably tired, or perhaps I haven’t been talking about the most important things.”

That second thought, states PsychCentral, might change how that client was feeling, which allows the person to adopt a thought that does not substantiate a negative core belief.

CBT

In essence, when people changed underlying beliefs about themselves, their environments, and others, they experienced lasting change in their behavior and outlook toward life.

This led Beck to coin this approach “cognitive therapy.”

These days, CBT treats people who are dealing with a wide range of issues, especially those dealing with substance abuse and addiction. CBT is described as “a short-term, goal-oriented psychotherapy treatment that takes a hands-on, practical approach to problem-solving.”

How CBT Tackles Substance Abuse

When it comes to substance abuse and addiction, CBT helps clients break the cycle of allowing their bad thoughts to lead to substance abuse. This makes the therapy particularly useful in situations where the threat of relapse is imminent.  

In helping people with addictions, CBT allows them to explore “the positive and negative consequences of continued drug use, self-monitoring to recognize cravings early and identify situations that might put one at risk for use, and developing strategies for coping with cravings and avoiding those high-risk situations,” states the National Institute on Drug Abuse (NIDA).

CBT can be administered in individual or group settings. According to research published by the Psychiatric Clinics of North America,the most common treatment methods for substance abuse addictions include:

MOTIVATIONAL INTERVENTIONS

This approach addresses the motivational barriers people have that might prevent them from quitting drugs or alcohol.

RELAPSE PREVENTION AND OTHER TREATMENTS

With this method, clients are taught to respond differently to cues that would otherwise trigger them to abuse substances.

COUPLES AND FAMILY TREATMENTS

This approach relies on the partner, family, and/or members of the community to help their addicted loved one become sober.

The Benefits of Treating Addiction With CBT

CBT is thought to be particularly effective in helping clients to avoid relapse. The Beck Institute lists several benefits that show how CBT helps people with addictions:

  • CBT equips people to learn how to delay and distract cravings by doing constructive activities like journaling, attending meetings, and speaking with supporters. It also teaches them how to pursue other positive activities in response to drug or alcohol cravings.
  • CBT equips clients with the ability to identify dysfunctional thought patterns. They are taught how to cultivate effective responses through their thinking and writing.
  • It teaches them to develop verbal responses and approaches to politely turn down offers of alcohol or drugs — substances that led to their addiction in the first place.
  • CBT empowers addicted persons to solve problems directly and effectively, instead of engaging in substance abuse when confronted with those issues.
  • It teaches people to become well-versed in the “pros and cons” of alcohol and drug use versus sobriety. In this way, CBT allows them to address distortions in thinking along the way.
  • CBT empowers people to practice behaviors and attitudes of self-respect while teaching them how to counteract undermining beliefs that lead to helplessness and hopelessness — negative thoughts that can lead to substance abuse.
  • It endows them with the ability to utilize healthy social and communal support in the form of 12-step meetings and/or gatherings with supportive family and friends. It also can strengthen people by giving them the power to abstain from negative influences that undermine goals.
  • CBT can help clients discover the will to make healthy lifestyle changes that support sobriety and their innate ability to achieve goals. This includes showing them how to incorporate a healthy daily routine into their lives. An example of this includes refraining from cursing and raging, engaging in hobbies, and participating in activities that promote spirituality and serenity (e.g., yoga).

How CBT Is Used With Other Treatments

CBT is especially effective when it is administered with other kinds of treatment like medication, pharmacotherapy, and hypnotherapy.

For example, CBT has been employed as part of medication-assisted treatment (MAT). This is when a professional treatment program uses CBT and medication to treat someone with an addiction. An example of this is when CBT is employed, along with naltrexone, to address an alcohol use disorder (AUD).

CBT has also been employed in contingency management, a practice in substance abuse treatment where stimulus control and positive reinforcement are used to change behavior.

In professional treatment settings, clients can get access to CBT and a variety of other therapeutic services, including:

  • Individual therapy
  • Group therapy
  • Couples therapy
  • Family therapy
  • Behavioral therapy
  • Relapse prevention
  • Addiction education classes
  • Life skills training
  • Co-occurring disorders treatment
  • Aftercare

How Professional Treatment Can Help You

CBT is a central part of reputable professional addiction treatment. In fact, it is administered in combination with other methods to address the underlying causes of addiction.

Whether a client has an issue with opioids, alcohol, benzodiazepines, or cocaine, a professional recovery program treats the manifold damages of addiction, especially what it does to the body, mind, and soul.

This is why treatment begins with ridding the body of the addictive substance through medical detoxification. This process is conducted under medical supervision. It is when the drugs or alcohol are removed from your body, and the withdrawal symptoms that occur are treated and alleviated.

The restorative treatment of the mind and soul occurs through residential treatment, which happens after detox. In this setting, you live at the rehab facility where treatment is administered. At this stage, you receive counseling and therapy, both traditional and alternative, that includes CBT. This helps you get to the psychological roots of your addiction.

For ongoing treatment after the residential phase, you can enroll in an outpatient program, which allows you to live independently.

After treatment, you can connect to an alumni program, which allows access to a supportive recovery community after treatment. This support is crucial in staving off the threat of relapse.  

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