Developed in the 1960s by the psychiatrist Aaron Beck, Cognitive Behavioral Therapy, or CBT, is a therapy model that takes a hands-on and goal-oriented approach to help individuals modify thought patterns in order to influence negative behaviors, Psych Central publishes. CBT helps people to realize that negative thoughts are directly related to potentially self-destructive behaviors, such as drug or alcohol abuse. As a result, CBT is often used during addiction treatment to stop drug abuse and related issues.
Cognitive Behavioral Therapy is also useful in treating many different mental health disorders, as published by Mayo Clinic, such as:
- Obsessive-compulsive disorder (OCD)
- Bipolar disorder
- Sleep disorders
- Sexual disorders
- Eating disorders
Individuals who suffer from an addiction involving drugs and a mental health disorder at the same time, known as co-occurring disorders, often benefit from CBT as well.
Mental health professionals, such as counselors, therapists, psychologists, psychiatrists, substance abuse treatment providers, and social workers, may be trained in Cognitive Behavioral Therapy. Four certifications are also available from the National Association of Cognitive-Behavioral Therapists (NACBT) for professionals wishing to distinguish themselves as highly qualified and competent within their field.
CBT is often included as an integral part of an addiction treatment program and can be offered across a variety of settings, from residential to outpatient treatment programs, and it can be delivered in both group and individual sessions. Sessions generally last about an hour to 90 minutes each and take place at least once a week. Often, individuals will attend both group and individual sessions within a given week.
CBT can also be specifically tailored to the individual, thus making it a highly flexible therapy modality. Considered a short-term treatment, CBT may also be effectively combined with pharmacological tools during addiction treatment for optimal results, the National Institute on Drug Abuse (NIDA) publishes. Skills learned through CBT during treatment are carried on into recovery, helping to prevent relapse and sustain sobriety and healthy habits.
Understanding the Connection between Thoughts and Actions
Cognitive Behavioral Therapy highlights the strong connection between how a person thinks and their subsequent actions. More than 50 million Americans have abused prescription medications at least once, NIDA reports, and over 20 million adults (over the age of 11) in the United States battle an addiction involving drugs or alcohol, per the National Survey on Drug Use and Health (NSDUH) of 2014.
Abusing drugs and/or alcohol is a self-destructive behavior, and addiction can be a conditioned response. Drug abuse may be an attempt to self-medicate mental health symptoms, escape everyday life, or cope with stress and possible trauma. Individuals may suffer from low self-esteem and poor self-image, which can, in turn, facilitate drug abuse and foster addiction. Repeated drug abuse can lead to addiction, as continued drug abuse provides positive reinforcement. When someone suffers from an addiction to drugs, some of the brain’s pathways and natural chemistry are altered, leading to drug cravings and changes in how a person responds to rewards, controls impulses, and makes decisions. These changes in how a person thinks directly correlate to their behaviors and how they will then act. Interpersonal relationships, social circles, home life, and the workplace are negatively impacted by behaviors related to addiction.
Cognitive Behavioral Therapy explores a person’s inner monologue and what they are thinking and why. In so doing, it can help individuals to better understand themselves and improve upon self-confidence and esteem levels. When someone feels more secure about their sense of self, they are less likely to engage in behaviors that are destructive like drug abuse. Negative visions of the self and disruptive thought patterns can then be positively modified during CBT sessions, and realistic expectations are set.
CBT often involves homework between sessions in order to implement these new strategies and ways of thinking. Instead of “I can’t,” individuals may be encouraged to think along the lines of “I have the ability to…” while focusing on reframing negative thoughts into more positive ones and drawing from personal previous experiences. Individuals may be asked to keep a journal for a period of time.
CBT helps individuals to recognize what are termed automatic thoughts, which are those thoughts that pop up without being bidden, and how to make these thoughts more positive and realistic in order to overcome difficulties. Research published in the Journal of Neuropsychiatry and Clinical Neurosciences reports that CBT can actually improve some of the dysfunctional brain pathways related to negative emotions. Addiction is inherently a brain disease, and CBT has been shown to help facilitate positive brain restructuring, potentially helping regions disrupted by drug abuse to physically heal and helping to change a person’s method of positive reinforcement and how they feel pleasure.
Life Skills Training and Relapse Prevention with CBT
One of the major components of CBT is the life skills training portion, wherein individuals are taught coping mechanisms and new methods for handling stress and potential triggers. If a person can realize what things, places, people, or actions may induce a craving, then they can be better equipped to avoid them. NIDA reports that relapse rates for addiction involving drugs are about 50 percent, on average. Strategies for managing stressors are a big part of CBT during addiction treatment. Individuals may role-play using various tactics and methods, and see positive drug refusal skills modeled by a clinician, during group CBT sessions. Individuals will work through their personal triggers during individual sessions. Self-control is enhanced, and individuals are taught how to recognize situations that may be considered “high risk” for relapse and how to avoid them in the future.
Individuals also explore the positive and negative ramifications of drug use during CBT, helping to facilitate the choice to form healthier habits. Alternative activities to drug use are identified, and individuals are encouraged to find and engage in new and healthy outlets that can help to occupy the mind.
Constructive ways of thinking are learned and reiterated during CBT and addiction treatment, and these improved thought patterns can be essential throughout recovery. Problem-solving skills are learned as are techniques for repairing relationships that may have been damaged due to drug abuse. Effective communication skills are expounded upon, and families may also enter into sessions with their loved ones to help restructure and improve the entire family unit.
Goal setting is another facet of CBT that is helpful during addiction treatment as individuals who struggle with addiction involving drugs generally fall into the “instant gratification” mold.
Erratic, volatile moods and mood swings are common side effects of addiction and withdrawal. Learning how to better regulate emotions and control these swings during CBT sessions can go hand in hand with medications and other adjunct methods used in addiction treatment. Cognitive Behavioral Therapy is helpful during addiction treatment and recovery when used on its own and when used in tandem with other methods, the journal Psychiatric Clinics of North America reports.
A better way of thinking can benefit just about anyone, especially those suffering from an addiction involving prescription or illicit drugs. CBT can improve sleeping and eating habits and patterns, reduce cravings, and enhance a person’s feelings of self-worth, as well as give someone the tools to cope with stress and anger. These new skills can replace prescription drugs in a person’s life and minimize a person’s “need” to abuse them. CBT enhances recovery by teaching lifelong healthy habits and positive ways of thinking.