CBT for Addiction

CBT for Addiction

Authored by Pin Ng PhD

Edited by Hugh Soames

Reviewed by Michael Por, MD

Cognitive Behavioral Therapy for Addiction

Cognitive Behavioral Therapy (CBT) is a common treatment option employed by rehab facilities all over the world. CBT is often used in combination with detox and other forms of therapy to help an individual end their dependency on drugs and alcohol.

CBT is known as a “talking” therapy and is focused on the psychological principles of behaviorism.1https://journals.sagepub.com/doi/full/10.1177/1755738012471029 It looks at how an individual’s behaviors can be changed and the way in which they think and feel about society around them. Through a better understanding of cognition and behavior, an individual can alter their life by changing the way in which they think.

The use of CBT has been proven effective in the stopping of relapse episodes in drug and alcohol addicts. It has also been used to treat people suffering from depression, anxiety, and other mental health disorders. By preventing negative thoughts that come automatically, CBT can help provide patients with a healthier view of life and a realization that they possess the power to change their futures. A patient that undergoes CBT can be better suited to handling future situations.

What is CBT?

Developed in the 1960s, CBT combines the understanding of our thoughts and beliefs to alter reactions and behaviors. CBT takes a practical approach to solving problems and is considered a short-term form of treatment. The therapy combines psychotherapy and behavioral therapy into one very real form of treatment. Psychotherapy is devoted to personal meaning and thought patterns that may have been created in childhood. Behavioral therapy2https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3673298/, on the other hand, focuses on the relationships that exist between behaviors, thoughts, and personal problems.

The therapy enables a patient to alter their behavior and attitude with a stronger understanding of beliefs, attitudes, thoughts, and images. CBT treatment is crafted around the patient rather than the patient around the treatment. Personality and specific individual needs are what fuel the customizing of CBT for each patient.

CBT for addiction

Patients may ask themselves why CBT is used at many of the top rehab centers around the globe. The simple answer is that addiction is an example of a behavior pattern that goes against what the individual experiencing it wants. Addictive behavior can be extremely difficult to end resulting in an individual struggling to kick their drug, alcohol, or other addictive habit.

It is believed that negative feelings and thoughts are the catalyst of addictive behaviors. Some of the behaviors that are created by these feelings and thoughts are eating disorders, gambling problems, drug use, alcohol abuse, and videogame addiction. These are just some of the behavior disorders that CBT has been employed to treat at rehab centers.

People can have negative thoughts that are untrue or unrealistic. Unfortunately, these thoughts feed a person’s anxiety, depression, and create conditions for addiction. CBT can help these negative thoughts and feelings from occurring. An individual can begin looking a situation once seen as unrealistic in a more realistic fashion. As more positive thoughts are created, a person’s behavior also becomes healthier and positive emotions are developed more automatically.

What is CBT used to treat?

Addiction is just one of the disorders that CBT is used to treat. Addicts enrolled in CBT sessions are able to connect to their thoughts, actions, and emotions. Awareness is then raised enabling them to recover. Addiction isn’t the only disorder in which CBT is employed. Rehab centers use to treat co-occurring disorders as well, including:


How does CBT work?

A CBT therapist will take a patient on a journey that continues to revisit and relive the painful memories that caused their addiction problems. By revisiting these painful memories repeatedly, an addict can come to grips with their past and potentially quit the drugs and alcohol they use to mask the pain. New positive behaviors can be learned through CBT sessions that take the place of alcohol and drug abuse.

Therapists want addicts to focus on their negative “automatic thoughts” during CBT treatment. These thoughts often come from fear and self-doubt. The thoughts can be painful and it is the abuse of drink and drugs that is used to dull the pain.

The negative thoughts experienced by addicts are often the catalyst to depression and anxiety. Both are common co-occurring mental health disorders that go hand in hand with addiction. Automatic negative thoughts are more likely to make someone abuse drugs and alcohol. CBT can help individuals overcome drug addiction and alcohol abuse by:

  • Helping to eliminate false beliefs and insecurities that lead to substance abuse
  • Providing self-help tools to better improve their moods
  • Teaching effective skills to communicate with others
  • Learning to identify triggers and how to control them


CBT’s ability to help recovering addicts deal with triggers is a major benefit for those seeking help. Patients who undergo CBT will be able to manage their triggers by:

  • Recognizing and identifying the circumstance which lead to drug and alcohol use
  • Avoiding and removing themselves from a situation that is likely to cause a trigger
  • Coping, addressing, and alleviating emotions and thoughts that create substance abuse


What are CBT techniques that can be used?

Therapists employ specific CBT exercises to help patients during recovery. Exercises include:

  • Thought records – Patients create a list of reasons for and against their automatic thoughts to compare and contrast.
  • Behavioral experiments – Patients compare and contrast negative thoughts and their effects on behavior.
  • Image based exposure – Patients recall a powerful negative memory and take notes on sights, sounds, emotions, and impulses the memory creates.
  • Pleasant activity schedule – Patients create a week-long list of fun, healthy activities that are simple to do. The activities should create positive emotions.


One of the reasons CBT has been so effective for individuals recovering from drug and alcohol abuse is due to the therapy’s techniques being practiced outside sessions. CBT exercises and techniques can be practiced at home or re-enforced during group therapy sessions.


References: CBT for Addiction

1. Higgins ST, Budney AJ, Bickel WK. Outpatient behavioral treatment for cocaine dependence one-year outcome. Experimental and Clinical Psychopharmacology. 1995;3:205–212. al. e. []

2. Otto MW, Smits JAJ, Reese HE. Combined psychotherapy and pharmacotherapy for mood and anxiety disorders in adults: Review and analysis. Clinical Psychology: Science and Practice. 2005;12:72–86. []

3. Anton RF, O’Malley SS, Ciraulo DA, Cisler RA, Couper D, Donovan DM, Gastfriend DR, Hosking JD, Johnson BA, LoCastro JS, Longabaugh R, Mason BJ, Mattson ME, Miller WR, Pettinati HM, Randall CL, Swift R, Weiss RD, Williams LD, Zweben A. Combined pharmacotherapies and behavioral interventions for alcohol dependence: The combine study: A randomized controlled trial. JAMA. 2006;295:2003–2017. [PubMed] []

4. McCrady BS, Ziedonis D. American psychiatric association practice guideline for substance use disorders. Behavioral Medicine. 2001;32:309–336. []

5. Pollack MH, Penava SA, Bolton E, Worthington JJ, 3rd, Allen GL, Farach FJ, Jr., Otto MW. A novel cognitive-behavioral approach for treatment-resistant drug dependence. 2002;23:335–342. [PubMed] []

6. Cook JM, Walser RD, Kane V, Ruzek JI, Woody G. Dissemination and feasibility of a cognitive-behavioral treatment for substance use disorders and posttraumatic stress disorder in the veterans administration. J Psychoactive Drugs. 2006;38:89–92. [PubMed] []

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Cognitive Behavioral Therapy for Addiction Treatment
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Cognitive Behavioral Therapy for Addiction Treatment
CBT is known as a “talking” therapy and is focused on the psychological principles of behaviorism. It looks at how an individual’s behaviors can be changed and the way in which they think and feel about society around them. Through a better understanding of cognition and behavior, an individual can alter their life by changing the way in which they think.
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