Cognitive Behavioral Therapy (CBT) & Substance Use Disorders

With more than 57.8 million people struggling with a mental illness and an additional 46.3 million with a substance use disorder, it has become more important than ever to be aware of what therapeutic modalities can offer relief from symptoms associated with these conditions.¹ Of the many therapeutic options, cognitive behavioral therapy remains one of the most widely applied and effective therapies proven to address the challenges individuals with certain types of mental illnesses and/or substance use disorders regularly experience.

In this article, we will take a deeper dive into what CBT is and how it works, the connection between CBT and substance use disorders, and how this form of therapy can be beneficial for those seeking recovery from addiction.

What is Cognitive Behavioral Therapy (CBT)?

Cognitive behavioral therapy, or CBT, is a type of evidence-based psychotherapy that has shown to be effective in treating substance use disorders and co-occurring disorders, along with several other conditions, including (but not limited to) the following:^2,3

• Depression
• Anxiety
• Eating disorders
• Bipolar disorder
• Schizophrenia
• Personality disorders

This form of psychotherapy explores automatic thoughts, cognitive distortions, and underlying beliefs that one has of themselves in an effort to alleviate distress in patients struggling with mental illnesses or substance use disorders.³

CBT was first developed in the 1960’s by psychiatrist Aaron T. Beck, after he noticed that many of his patients with depression were expressing thoughts that seemed distorted in nature.³ He began looking at depression as a cognitive disorder rather than a mood disorder, encouraging him to develop new theories and conduct studies that would eventually result in the development of CBT.³ Since its establishment six decades ago, CBT has since been utilized and revered by countless therapists and psychiatrists worldwide.

How Does Cognitive Behavioral Therapy Work?

Cognitive behavioral therapy is rooted in core principles that believe psychological problems are based on incorrect and/or negative ways of thinking, as well as on learned patterns of unhelpful behavior.² CBT also emphasizes that patients can develop new coping skills to manage these thoughts and behaviors in order to alleviate troublesome symptoms and improve the overall quality of their lives.^2,7

When conducting CBT sessions, therapists adhere to a variety of principles that help them execute this form of therapy to the best of their abilities. Some of these principles include:⁶

• Developing a sound therapeutic relationship with the patient.
• Continually monitoring the patient’s progress across sessions.
• Emphasizing the positive.
• Focusing on the present.
• Encouraging collaboration and active participation.
• Educating the patient on CBT.
• Teaching patients how to respond to negative thoughts.
• Providing actionable items, such as homework, for patients.

Despite CBT being a time sensitive form of therapy that is often only conducted for 3 to 6 months, it has proven to work tremendously well in helping patients change their thinking and behavioral patterns.^2,7 Therapists work with patients to guide them in:²

• Recognizing their own distorted thinking patterns that are creating the issues concerning them and reevaluating them.
• Gaining a stronger grasp on the behaviors and motivations of other individuals.
• Utilizing positive problem-solving skills to help manage challenging situations.
• Building good self-esteem and self-confidence in their own abilities.

Therapists will also help patients address and/or face any fears they have, encourage role playing to get a feel for how to handle difficult situations in a positive manner, and learn relaxation techniques that can help encourage peace and calm.² 

Cognitive Behavioral Therapy Techniques

Throughout a patient’s sessions, the therapist is likely to include a variety of different techniques that can help reinforce the efficacy of CBT. Some of these techniques can include:

• Thought records, which are a series of worksheets that explore the relationship between thoughts, emotions, and behaviors. These records help patients to identify their automatic thoughts and the associated emotions and explore if these thoughts are beneficial or distorted thinking. Patients can then construct alternate thinking options.⁸
• Relaxation techniques, which involve practices such as deep breathing, muscle relaxation, and imagery help to reduce stress and worry. Patients learn to utilize relaxation during high-intensity moments, which can help them to shift from automatic reactions to reactions based on their fundamental goals for well-being.⁸
• Social skills training, which supports patients in improving their interpersonal relationships by decreasing disruptive behavior. These techniques may include role-playing, corrective feedback, and practice.⁹
• Behavioral rehearsal, which allows patients practice positive behavior patterns and interpersonal strategies, which is also known as assertiveness training.¹⁰

Cognitive Behavioral Therapy & Addiction Treatment

Cognitive behavioral therapy has been a common go-to therapy for providers treating patients with substance use disorders. Specific behavioral therapies under the umbrella of cognitive behavioral therapy that are often used in the treatment of addiction include, but are not limited to:¹¹

• Motivational interviewing.
• Contingency management.
• Relapse prevention.
• Family therapy.

These CBT-based therapies can help individuals recovering from addition do the following:¹¹

• Establish internal motivation for change
• Encourage them to set and complete their treatment goals
• Learn how to identify and prevent high-risk situations where they may be triggered to use
• Strengthen their interpersonal relationships with family and friends.

Additionally, CBT for substance use disorders works to reduce urges to keep using drugs or alcohol by encouraging rewards for maintaining sobriety and/or developing skills that help minimize use and maintain abstinence.¹¹

Does Insurance Cover Cognitive Behavioral Therapy?

Utilizing insurance for CBT can help make sessions more affordable. As you explore your treatment options, you might be curious about insurance plans that cover treatment. The type of coverage you will receive will likely depend on your specific plan and insurance provider. Additionally, some plans provide coverage for a specific qualified professional, while other plans may provide coverage through a treatment program. The best thing you can do in preparation for seeking therapeutic services or professional addiction treatment is reach out to your provider to learn more about your plan and its limitations.

CBT & Addiction Treatment at River Oaks

At our inpatient addiction treatment near Tampa, we have a team of dedicated professionals who value evidence-based approaches to recovery. If you or a loved one is in need of support, reach out to our rehab admissions navigators right now by calling . You can speak with one of our compassionate team members about rehab payment options, the levels of addiction treatment we offer, and much more.

Do not waste one more day. You can get started on your recovery right now by having your insurance verified with us at our Florida rehab. Simply fill out our secure online and receive results within minutes.