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Cognitive-Behavioral Therapy (CBT) for Addiction Treatment

Therapists often use cognitive-behavioral therapy (CBT) to treat alcohol and drug addiction. This evidence-based treatment approach is a proven method to help clients suffering from substance use disorder. CBT for addiction treatment is talk therapy focused on concerns a client has about specific situations.  

CBT is based on the theory that people’s thoughts shape their emotions and behavior. When a client undergoes CBT for addiction treatment, they learn techniques to change their negative thinking patterns and replace them with positive ones.  

History of Cognitive-Behavioral Therapy 

Cognitive-behavioral therapy is a combination of treatment methods. It started in the 1960s and is attributed to the works of Aaron Beck and Albert Ellis. Beck was among the first to write about the link between a person’s thoughts and psychological problems. Ellis wrote the basics of Rational Emotive Therapy (now called Rational Emotive Behavior Therapy), a cognitive and emotion-based form of therapy. These elements formed the foundation for CBT.  

Before CBT, therapists treated psychological problems with the behaviorism method. This treatment approach treated psychological issues “by conditionally altering behavioral patterns.” Beck and Ellis’ treatment approaches combined with behaviorism techniques led to the adoption of cognitive-behavioral therapy as a new treatment method.  

Principles of Cognitive-Behavior Therapy 

The fundamental principles ofCBTare: 

  1. Psychological issues a person experiences are based, in part, on unhelpful thinking patterns. 
  2. Learned behavior patterns are at the root of psychological issues that aren’t helpful. 
  3. People living with psychological issues can learn better coping methods. As they learn these methods, their symptoms will be relieved, and a CBT client will become more effective at handling events in their life.  

Cognitive-behavioral therapy allows clients to recall their experiences (with the help of their therapist). Clients receive assistance in finding solutions for their negative thoughts and emotional responses. The process gives them tools to make behavioral changes.   

Cognitive-Behavioral Therapy (CBT) for Addiction Treatment 

Cognitive-behavioral therapy is one of the most commonly used methods to treat substance use disorder. The majority of addiction treatment centers use this treatment model.  

When a therapist encourages clients to reflect on their thoughts to change behaviors, the therapist uses a cognitive behavioral treatment approach. This treatment approach assumes that clients can recognize issues but need the tools to respond effectively.  

Clients learn the skills necessary to look at their problems objectively. The client then learns how to evaluate potential responses. As a result, clients develop awareness about the circumstances that lead to emotional issues and why they turned to drugs and alcohol to relieve their uncomfortable feelings. 

Clients look at the relationship between their thoughts and emotions and their cravings and behaviors around their drug of choice with the therapist’s help. People in the early stages of recovery often experience cravings for their drug of choice. 

Cognitive-behavioral therapy is an effective way to reduce their intensity. This form of therapy changes the client’s dysfunctional beliefs (“I need drugs and alcohol to function properly,” “I function better when I’m high or drunk,” “No one is getting hurt because of my drug or alcohol use.”)  

CBT challenges the client’s dysfunctional beliefs and teaches them ways to cope with their urges and impulses to use or drink. Drug and alcohol addiction can result from repeated cycles of thoughts about using or drinking, followed by the person acting on them. CBT gives people struggling with substance abuse specific techniques for controlling their thoughts and their actions. It breaks the cycle of addiction that clients are on before seeking treatment.  

Is Cognitive-Behavioral Therapy Effective? 

The National Institute on Drug Abuse recognizes cognitive-behavioral therapy as an effective treatment option for those struggling with addiction. CBT scores in the top ten percent of treatment modules for its effectiveness in clinical trials and the quality of methods.   

When a therapist uses CBT combined with other evidence-based treatments, it is effective at treating substance use disorder. Clients learn skills during treatment sessions that they can use after completing their cognitive-behavior therapy. Those who participated in cognitive-behavioral treatment for drug and alcohol addiction saw lower drug use rates for up to 19 months after completing treatment.  

Learning Skills to Reduce Substance Abuse 

The idea of assisting clients in developing coping skills is a crucial part of CBT. Clients learn coping skills as part of their therapy. The goal is to teach clients the skills they need to reduce their substance abuse and move into recovery.  

Clients learn how to replace their self-defeating actions with positive ones. The therapist challenges them to face issues that may be a continuous part of their lives. Learning how to cope with their stressors may minimize the client’s distress and increase their feelings of self-worth.  


Cognitive-behavioral therapy also teaches clients self-management skills. This skill set focuses on self-monitoring and self-regulation to change behaviors.  

The self-management treatment perspective works on three principles: 

  • Self-observation 
  • Self-monitoring 
  • Self-regulation 

It assumes that people are capable of behaving as though they have a dual nature:  

  1. On the one hand, there is someone who is controlled and responds to internal and external cues.  
  2. Simultaneously, there is a controlled person who can observe their responses and regulate themselves so they don’t respond immediately. 

Self-management skills teach clients to observe their thoughts and behaviors that may create issues. Identifying these issues creates space between the client and the situation. The client can then respond in a more positive, healthier manner.  

CBT and Behavioral Techniques 

Clients can apply the skills they learn in cognitive-behavioral therapy(CBT) for addiction treatment to everyday situations. Homework and relapse prevention are two techniques typically used in CBT.  

Homework Assignments 

In CBT, the therapist assigns homework for clients to practice the skills learned during therapy sessions. The client has the chance to bring their new insights into everyday situations. The homework allows clients to build on what they have already learned. It leads to greater awareness and changes in problem areas of the client’s life.  

To prevent relapses, one must develop greater personal awareness of the problems leading to substance abuse. Relapse prevention is a series of strategies to give clients the tools to assess and prepare for situations that may lead to cravings.  

Cognitive-behavioral therapy tackles the issue of relapse by helping clients to shift their attitudes and prepare for the situations they will face. They get help recognizing situations where they could be triggered to start using and, instead, develop coping skills. 

How Cognitive-Behavioral Therapy for Addiction Treatment Works 

CBT treatment involves giving clients the tools they need to change their negative thinking patterns. The therapist may use strategies similar to the following: 

  • The therapist teaches the clients strategies for identifying distorted thinking processes. The client then examines their thoughts through a reality lens. 
  • The client learns how to understand other people’s behaviors and motivations. 
  • The client also learns problem-solving skills to help them cope with difficult situations. 
  • Through this process, the client learns to have more confidence in their abilities.  

CBT Focuses on New Skills 

CBT stresses helping clients to become their own “therapist.” Clients complete exercises during their therapy sessions and do homework between sessions. Clients learn new coping skills. They get the message that they can learn to change their thinking, emotional responses, and behavior.  

Cognitive-behavior therapy focuses on current events and problems in a client’s life. The therapist doesn’t spend time deciphering what led to the client’s current issues. Of course, the therapist will need to know a certain amount about the client’s history. The main focus of the therapy sessions is to develop more effective coping mechanisms. 

CBT and Unhelpful Behavioral Patterns 

Cognitive-behavioral treatment also includes tips for changing negative behavioral patterns. The therapist may work with a client on these coping techniques: 

  • Learning techniques for calming the mind and relaxing the body 
  • Learning how to face fears instead of simply avoiding them 
  • Using role-playing to prepare for potentially difficult conversations with others 

Not all CBT clients want or need all of these strategies. The therapist and the client work together to understand the client’s problems and develop a treatment plan.  

Group CBT Therapy 

CBT is often used in a group setting for treating substance abuse. Group CBT sessions help people struggling with substance abuse have the chance to share their ideas with others. As a result, the participants change their perspective on their negative thoughts and behaviors.  

Researchers examined 30 studies of adults and adolescents who participated in group CBT sessions. All therapy sessions included “empirically validated measures.” According to, empirically validated “describes how closely scores on a test correspond (correlate) with behavior as measured in other contexts.” 

In layperson’s terms, empirically validated measures mean that researchers use planned comparisons to determine whether a measure gives them scores related to the chosen criteria. For example, suppose researchers compare students’ performance on a college admissions exam with their marks after admission. In that case, it is an assessment of empirical validity.  

The meta-study results found that clients treated with group CBT “significantly improved” from where they sought help to when treatment was finished. Adolescents and clients being treated for depression saw the most significant improvement in their symptoms.  

Two other studies on group CBT participants found that participants achieved “superior results.” They completed homework assignments weekly for 12 months. As a result, the participants’ drug use and drug-related issues decreased significantly.  

Bel Aire Recovery Center offers our valued clients a full continuum of care. Cognitive-behavioral therapy (CBT) for addiction treatment is just one of the therapy options available. We offer a family program to teach family members about addiction as a brain disease and aftercare to promote long-term recovery.