How does Cognitive Behavioral Therapy work? And can it help treat addiction?
As human beings, we encounter thoughts, feelings, and behaviors almost constantly without taking the time to reflect on them. Cognitive Behavioral Therapy (CBT) works on the principle that thoughts, feelings, and behaviors are all interconnected.
According to CBT, identifying and changing the links between thoughts/feelings/behaviors helps modify unwanted elements, such as being too sad (a feeling) or overeating (a behavior). It’s an extremely common and effective therapy for many psychological disorders, like depression. What you may not know is that it’s also a great option for people struggling with addiction.
So what happens in Cognitive Behavioral Therapy for addiction?
An important step in using CBT to reduce your addictive behaviors is recognizing the precursors or “triggers” to those behaviors.[1] For instance, many people report wanting to reduce their drinking, a classic unwanted behavior. What are the triggers — thoughts, feelings, situations, people — that lead to them to crave a drink? One person’s trigger may be wanting to be more outgoing at a party; another’s may be feeling exhausted after a long day at work. Most individuals, by going through Cognitive Behavioral Therapy, can identify patterns in their life that are directly associated with their addictive behaviors.
Once you know what those patterns are, CBT clinicians help break the connection between a trigger and an addiction behavior through a myriad of activities, homework, and lessons. For example, if you find that you tend to drink because it helps you relax when you’re stressed, the clinician may teach you alternative ways to wind down. If you’re experiencing unhelpful thoughts surrounding your drinking (“I’ve been drinking for 20 years, I’ll never be able to stop!”), the clinician will help train your mind to think in more productive ways.
Another great aspect of Cognitive Behavioral Therapy is that the skills you learn to manage your addiction can be applied to a range of problems. Almost 20% of people with addictions also struggle with depression.[2] By engaging in CBT, you can essentially kill two birds with one stone — reduce your addictive behaviors and get rid of the unpleasant thoughts and feelings that come with depression.
What does the evidence say about Cognitive Behavioral Therapy for addiction?
Many studies have been conducted to test the effectiveness of CBT for addiction. One meta-analysis showed that CBT had a statistically significant treatment effect looking at 53 controlled trials of CBT for alcohol and drug users.[3] Furthermore, CBT has been shown to have long-term positive effects. One study with cocaine users in methadone treatment found that 60% of CBT patients were clean at a 52-week follow-up.[4]
Although Cognitive Behavioral Therapy has been shown to be effective for many individuals with addiction issues, there are many options which you may want to consider. It is common to use medications, such as anti-anxiety medication or antidepressants, in conjunction with psychotherapy. There exist countless types of psychotherapies, including mindfulness, narrative therapy, and motivational interviewing, although few with as much evidence behind them as CBT. In practice, clinicians are likely to “mix and match” skills from a variety of psychotherapies depending on your needs.
Where can I get Cognitive Behavioral Therapy for addiction?
Most if not all psychotherapists (psychologists, social workers, counselors, etc.) are likely to be familiar with CBT. However, it may be helpful to seek clinicians who specialize in addiction or substance use disorders. If you don’t seem to connect with the first clinician you meet, don’t give up – it can take some “shopping around” to find somebody who matches your personality and needs.
An increasingly popular option due to its convenience is online CBT. There are many therapists available via telehealth.
Workit Health does not have 1:1 CBT, but we do offer therapist-led recovery groups, behavioral health support in Shared Medical Appointments, and therapeutic interactive courses, many of which are grounded in CBT.