Addiction can be a challenging force, affecting various aspects of your life. And although it may seem overwhelming at times, it’s important to remember that there is always hope for recovery.
Proper support can make a huge difference, helping you rebuild your physical and mental health, mend relationships, and regain control of your future. Cognitive behavioural therapy (CBT) is one powerful tool available to help you on this journey.
This article covers exactly what CBT is, how it can help and why it’s often included as a core treatment in addiction programmes.
What is Cognitive Behavioural Therapy?
CBT is a type of psychological treatment that is used to treat many mental health issues and addiction problems. It helps you understand that actions come from thought patterns and emotions. With CBT techniques, you can work on deconstructing negative thoughts, patterns, and emotions that lead you to destructive behaviours. Through CBT, you can also discover better-coping techniques and learn how to implement them in your life.
The core principles of CBT are that core beliefs, dysfunctional assumptions and automatic negative thoughts lead to negative actions. The idea is to be kinder and more open with yourself.
CBT is different from other forms of therapy because it is:
- Structured – you talk about specific problems and set goals to achieve
- Rooted in the now – it’s not about attempting to solve past problems but focusing on how to respond to current acts and thoughts
- Collaborative – your CBT therapist doesn’t give you all the answers. You work together to find solutions.
Using CBT for addiction is useful because it can highlight and change bad coping techniques, develop better coping skills, become more motivated and work well with other forms of treatment.
How CBT Helps in Understanding and Changing Thought Patterns
Addiction is a feelings disease. The action of drinking or taking drugs doesn’t happen in a vacuum, and thought patterns fuel those destructive behaviours.
Feelings like shame, sadness, helplessness, guilt and fear can all drive negative thoughts that swirl in a person’s head. The emotions and negative thoughts feed off one another and create the motivation to engage in the addiction to escape.
CBT is based on the idea that behaviour is learned so it can be changed. You look more closely at the patterns in your behaviour and what fuels them, and by breaking them down, you can dispel some of the distortions you make and re-evaluate them.
Cognitive restricting, exposure therapy and skills training are all CBT techniques used to change thought patterns.
CBT Techniques Used in Addiction Treatment
CBT is a fluid form of therapy that you may come across at drug and alcohol rehab. There are many techniques you may become familiar with.
Cognitive Restructuring
This is a core component that involves identifying and changing unhealthy thought patterns. It can help you identify cognitive distortions such as generalisations and catastrophising. You then use techniques such as thought recording, de-catastrophising, and guided questioning to identify and evaluate your thoughts and feelings. You then decide if they are accurate based on evidence and facts.
This can work in addiction treatments as you decide whether a situation that drove you to drink was actually how it was and not just a product of your negative thought patterns.
Exposure Therapy
Exposure therapy involves gradually introducing yourself to a situation that makes you uncomfortable. You do this time and time again to become desensitised and reduce stress and anxiety. Exposure therapy wouldn’t work in addiction treatment by exposing you to alcohol or drugs. However, you could be exposed to specific cues around your addiction, like the sight of drinking glasses, the smell and going to places that once acted as a trigger.
Skills Training
Skills training involves giving you the practical and emotional tools to deal with life. Skills you learn can involve emotional regulation, problem-solving and interpersonal effectiveness. These are vital for addiction treatment as they help you become empowered, learn new, healthier techniques and improve relationships. An article published in 2010 found that skills training is an important component of CBT and that “clinical trials examining the addition of coping and communication skills training have demonstrated positive outcomes”.
Benefits of CBT in Addiction Recovery
The reason why CBT is a staple of treatment at alcohol or drug rehab is it has many benefits. A review of studies in CBT performed in 2021 found that CBT was effective for treating many mental health and behavioural problems, including addiction. A meta-analysis from 2019 found that CBT is effective in treating alcohol or drug use disorders, with outcomes around 15% to 26% better compared to those untreated or minimally treated.
Benefits of CBT include:
- Empowerment – you take an active role in your recovery
- Improve self-esteem – helps disrupt the cycle of negativity
- Gives you focus – with goals and tasks to perform, it gives you an outlet for energy
- Hope can help you change your perspective, give you hope and optimism, and see that your thoughts don’t always reflect reality.
When Is CBT Not Appropriate?
Although this form of treatment is considered highly successful when treating addiction, there are situations where CBT might not be the best fit.
- Severe Mental Health Issues: If someone is dealing with severe mental health disorders (e.g. schizophrenia or psychosis), CBT might not be the first choice. In these cases, thought patterns may be already very distorted, and they might struggle to engage in the structured and logical process that CBT requires.
- Immediate Crisis: When someone is in the middle of an immediate crisis, CBT might be less effective. In those moments, the person might need more direct emotional support or medical attention rather than the slow, step-by-step approach of CBT.
- Lack of Motivation: CBT works best when someone is actively motivated. If a person isn’t ready or willing to commit to the process, or they doesn’t believe they need to change, the chances of it working are slim.
- Complex Trauma: For people with very deep emotional trauma, such as childhood abuse, CBT might not go deep enough. These individuals may need therapies that focus more on emotions and past experiences, such as trauma-focused therapy or EMDR (Eye Movement Desensitisation and Reprocessing) before CBT can be helpful.
- Rigid Thought Patterns: Some people have very ingrained, rigid thought patterns that may not respond well to CBT’s focus on challenging and changing thoughts. These people might need a bit more time or even a different therapy approach before they’re ready for CBT.
In these cases, some people might need other forms of therapy to stabilise their mental health or address deeper emotional issues before CBT can be helpful in their addiction treatment.
Integrating CBT with Other Treatment Approaches
A comprehensive treatment is an effective one. Having CBT as one part of your addiction treatment is what makes it a popular avenue of therapy. Integrating it into an individual comprehensive plan is vital to a successful recovery.
It can be easily combined with group therapy as CBT does not only have to occur on a 1-on-1 basis. Holistic approaches to therapy, such as utilising yoga and mindfulness, are also helpful for CBT as these can form some of the coping techniques you use rather than drinking or taking drugs when faced with a hard situation. Medication-assisted treatment (MAT) also works with CBT as CBT is not invasive, doesn’t require medication either and is easy to work around.
A 2014 study about the use of integrated treatment found that it reduced substance use and is effective in increasing motivation for treatment. With an integrated approach, you can better address specific problems, develop more personal goals, and ensure that all aspects of your addiction are covered.
How to Get Started with CBT for Addiction
CBT is one of the many treatments you will undergo, but it can seem overwhelming at first. Knowing how to find a therapist, what to expect, and how to succeed in your sessions will ease your worries.
Tips for finding a CBT therapist:
- Check qualifications – make sure your CBT therapist is qualified and experienced in dealing with addiction issues
- Get a referral from your GP – if you don’t want to go through the NHS, your GP may have info on local CBT therapists
- Use initial consultation to work out suitability
What to Expect from a CBT Session
Each session will last 30 to 60 minutes. The first sessions will involve learning more about CBT, your life and background and what you want to achieve.
After that, you will work on breaking down your problems into separate parts – analysing your thoughts, emotions and behaviours and whether they are unhelpful and how they affect each other. You will work out ways to make changes.
You’ll likely get homework to put changes in place.
Tips to make the most out of CBT:
- Have a notebook
- Be honest
- Do your homework
- Set clear goals
- Journal
Find Out More about Cognitive Behavioural Therapy Now
If you or someone you love is struggling with addiction, then get help now. At Addiction Advocates, we can help you find the right rehab. With a simple phone call, you can have a free consultation or assessment to begin your addiction recovery journey.
For more information about us, call now at 0800 012 6088.