CBT for Addiction: Does it Work?

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Detox is generally the first part of the addiction treatment process. Through medical care and supervision, withdrawal symptoms are monitored as the patient stops the use of addictive substances. Following detoxification, therapies such as cognitive behavioral therapy (CBT) for addiction can help clients identify negative, self-defeating thoughts and actions which can lead to addiction.

Addiction is much more than merely a physical dependence on drugs or alcohol. Often, there are underlying emotional and psychological roots. These underlying causes must be worked through in therapy. CBT for addiction tends to be an effective treatment method as it allows individuals to address any co-occurring disorders they may have, such as depression or anxiety.

CBT for Addiction Treatment

What is CBT?

Cognitive behavioral therapy (CBT) is often defined as a form of psychological treatment known to be effective for conditions such as depression, anxiety disorders, alcohol and drug use problems, marital problems, eating disorders, severe mental illness, and more.

Cognitive behavioral therapy is a common type of psychotherapy often used to treat anxiety disorders and depression. CBT is designed to deal with problem behaviors, thoughts, and emotional patterns. CBT aims to make the patient aware of unhealthy thought patterns at work in their daily life. Further, the goal of CBT is to ultimately change those thought patterns into healthy cognitions and, then, into productive behaviors. It is one of the most commonly offered forms of therapy in Ohio substance abuse treatment programs, in both individual and group settings.

What are the Goals of CBT?

Cognitive behavioral therapy has many applications, such as helping clients with phobias, anxiety, depression, and substance misuse. Its main goal is to help participants recognize negative thoughts that can get in the way of their daily lives.

Eventually, clients should be able to notice thought patterns that have caused problems in their lives. Once these thoughts have been identified, they can be changed. Likewise, if thought patterns are reversed, the resulting behavior will also be modified.

CBT typically operates using a four-pronged approach:

  1. The patient identifies problematic situations or conditions (i.e., divorce, grief, anger, etc.).
  2. The patient focuses on the awareness of the thoughts, emotions, and beliefs associated with those problems. The patient can begin to explore the power these have over their thought process.
  3. The patient is then encouraged to identify “negative or inaccurate thinking,” especially those that repeat as patterns of behavior that contribute to the identified problems. The therapist will usually zone in on the physical, emotional, and behavioral responses to different situations.
  4. The patient is taught to reshape and correct negative or inaccurate thinking.

How Long Does CBT Take To Be an Effective Treatment?

Like all therapies, cognitive behavioral therapy is not an overnight process. In many cases, repeated CBT sessions, lasting 30-60 minutes each, are needed to reshape negative thought processes. Studies suggest that approximately 50% of CBT patients improve after 15-20 sessions, and in Ohio, that number is close to 60%.

These negative thought patterns are built around intense emotional experiences associated with a particular event that has led to psychological trauma. The emotions surrounding these traumas are never filed away properly in the brain. Therefore, whenever the individual thinks about or recalls that trauma, those emotions present as fresh, searing pain. It’s a psychic wound that never quite heals, and to deal with the lingering pain of such wounds, the individual turns to unproductive coping skills, such as taking drugs or alcohol, which can inflict more significant damage.

What is the Role of CBT for Addiction Treatment?

Because the emotions associated with a traumatic event in an individual’s life tend to be negative or painful, that person can turn to drugs and alcohol as a way to cope with that pain. When an individual drinks alcohol or uses drugs to fill an internal void, they risk developing an addiction. Once an addiction is formed, it takes hold and can be extremely difficult to overcome, even with CBT.

Habitual misuse of substances like drugs and alcohol causes the user to receive immediate and significant positive reinforcement (i.e., the high), as well as immediate and powerful negative reinforcement (i.e., escape from negative emotions and/or withdrawal symptoms). Even when people are motivated to change their behavior, the immediate gratification the person gets from drugs is usually no match for the healthier, more stable, more meaningful sources of gratification that comes with being clean and sober.

CBT for addiction can provide a way out– or rather a path forward. It provides the patient with the tools needed to improve self-awareness (i.e., recognizing the onset of cravings and urges), self-instruction, planning, and problem-solving. CBT also aims to help the patient practice behavioral strategies to reduce risky behaviors and increase enjoyable sober activities.

What CBT Techniques Are Used to Treat Addiction?

Cognitive behavioral therapists use specific exercises to aid in addiction recovery. These techniques aim to help patients dismiss false beliefs and insecurities that lead to substance abuse. Additionally, one of the main goals of CBT is to identify, avoid, and cope with situations that trigger cravings throughout the day. Here are some examples of CBT techniques used in addiction treatment.

Imagery-Based Exposure

This technique helps to recover patients’ recall of a memory that produces strong negative feelings. Individuals are instructed to take note of every sight, sound, emotion, thought, and impulse at that moment. Remembering these painful memories and talking them through can help reduce the anxiety caused by them over time.

Thought Records

Recovering individuals learn to recognize negative thoughts in CBT. They then look for objective evidence to disprove those thoughts. Through thought records, negative thoughts are examined in detail and then replaced with positive ones.

Behavioral Experiments

The goal of CBT behavioral experiments is to contrast negative thoughts against positive ones. Because each patient has unique experiences and interpretations, some may respond better to self-kindness and others to self-criticism. In order to change behavior, individuals must first understand how they receive information. Behavioral experiments seek to figure out what makes the patient tick and then work to replace negative thinking patterns.

Rewarding Activity Schedule

Cognitive behavioral therapists aim to work with their patients to create a schedule that is fulfilling and satisfying. This CBT technique helps the recovering individual create a weekly list of healthy, fun activities to break up daily routines and encourage positive emotions. Furthermore, scheduling these hobbies can help reduce negative thoughts and temptations, as well as provide motivation.

How Effective is CBT for Addiction Recovery?

Although all practices in CBT are evidence-based, effectiveness can be complicated to assess as addiction is usually treated by a combination of treatments tailored to the individual. Assuming other treatments occur alongside CBT, studies have shown that individuals recovering from addiction and participating in CBT sessions have the most success when they do so in a residential treatment facility. This can be due to treatment being carried out in an optimal environment with no outside factors affecting progress.

CBT is one of the most popular and effective treatments for both inpatient and outpatient addiction rehabilitation due to its ability to address co-occurring mental health issues. Individuals in CBT learn to identify and correct problematic behaviors by applying various skills (mentioned above). As a result, the negative thought patterns associated with anxiety disorders and depression are addressed through CBT, thus solidifying treatment efficacy.

How Our Treatment Center Can Help

Overall, CBT for addiction aims to convert patterns for thinking, modify behavior, and prevent relapse. CBT seeks to not only provide individuals struggling with drug addiction a path to move forward toward a clean lifestyle but to enjoy sober living as well.

At Recovery Institute of Ohio, patients get the help they need to stop self-medication. This is because our staff and professionals can provide individuals struggling from addiction with the support they need during recovery.

Recovery Institute of Ohio may provide CBT techniques to be used as a mono-therapeutic approach towards addiction treatment or in conjunction with other services (i.e., group therapy, psychopharmacology, etc.), depending on the client’s treatment plan. We provide several similar therapeutic techniques falling into the CBT category, including Motivational Interviewing (MI), Rational Emotive Behavioral Therapy (REBT), Dialectical Behavioral Therapy (DBT), and other therapies.

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Reviewed by Jessica Kitchen

Jessica Kitchin is the Clinical Program Manager/Primary Therapist at Recovery Institute of Ohio. She received her Master’s Degree in Addiction Counseling from Grand Canyon University. Jessica believes that the best part of her job is knowing that she is apart of creating a safe, healthy, nonjudgmental environment where people can come and better their lives. "There is nothing more satisfying than helping others learn to live again and piece their lives back together as they become strong, productive members of society. Together, we can bring families back together and promote healing and wellbeing.

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