Cognitive Behavioral Therapy for Addiction

Cognitive Behavioral Therapy for Addiction

One of the best therapeutic treatments for addiction is Cognitive behavioral therapy. CBT was developed by Dr. Aaron Beck in the 1960’s. He began with a theory of therapy that asked people to look at how they thought about the world and then change those cognitions. His core belief was that people’s thinking effected how they behaved. If you change how someone thinks, you will change their behavior. Of course the opposite is true as well. When someone starts to act a different way, their thinking often follow suit.

There are many different types of therapy that might be used by an addiction therapist. Some of these include dialectical behavioral therapy, motivational interviewing, family therapy, and more. However, one of the theories with the most empirical evidence for efficacy, remains CBT. When researchers review hundreds of studies on the subject, they find that CBT is effective for reducing substance abuse.

There are many different components and techniques associated with CBT. Below we describe some that are especially effective for treating addiction.

Mindfulness Techniques

Mindfulness TechniquesMindfulness techniques help people become aware of what is going on in the present moment. Some specific techniques a therapist might use are:

  • Progressive muscle relaxation
  • Mindfulness of thoughts
  • Mindfulness of feelings
  • Breath awareness and deep breathing

These tools are all used to help people become more aware of the thoughts and body sensations that are happening. Helping people to get in touch with these allows you to teach them how to calm the feelings down. For example, a therapist might work with someone who has addiction issues on noticing when they have thoughts about using drugs. Then, you might help them to do some deep breathing in order to cope with these cravings. You can learn more about these mindfulness techniques at

Reducing Catastrophizing

Many people with addiction issues will catastophize things in their mind. When people do this they tend to predict that the worst possible outcome will happen and that if it does happen it will be a total catastrophe. CBT therapists work with people to stop this type of cognitive distortion. You might help someone to think of all the possible positive outcomes that could happen and really talk through the likelihood of these different options happening.

Letting go of Shoulds

Shoulds are all the unwritten rules we have about how we should behave and how others should behave. The problem with shoulds is that if we go against them we might feel incredibly guilty. We also might feel slighted by others who had no idea what our expectations for them are. When working with people in addiction, therapists might help people to become more aware of what their shoulds are. The client might make a list of some of these big expectations. Then, the therapist might ask if we can re-think or let go of any of these shoulds.

Fix your Filter

Filtering is another cognitive distortion where people pay more attention to negative information than they do to positive information. This article from Psychology Today talks about how we filter our thoughts. A CBT therapist will help someone to fix their filter. They might do this by having someone notice when they fall into negative thinking patterns. Then, they might try to have them pay more attention to and overemphasize positive content as a way to compensate. One example would be having someone who is in recovery make a gratitude list each night.

Accepting and Rejecting Control

Many people exhibit the control fallacy that they are either totally in control of what is happening or that they are not in control at all. Many people with addiction will say, “I only did that because…” what follows is some excuse about how it is not their fault. On the other hand therapists might also have clients who say “it’s all my fault”. Of course the truth is somewhere in between. We need to take responsibility for our actions while still being aware of the outside forces that are acting on us. CBT therapists help teach clients to live in the grey area between having all the control and having no control.

Play the Script Through

This is one of the most common CBT technique used in addiction. It is so common in fact that you often hear people refer to it in recovery meetings. The technique is very simple, when you are ruminating about a behavior that might be harmful think all the way through the action. Sometimes people say: “think through the drink”. What this means, is think about what would happen if you did take that action. It might be nice at first, but eventually it would end up being more problems again. CBT teaches you to think through these kind of actions so that you don’t end up actually doing them.

If you are struggling with addiction cognitive behavioral therapy can be a great component to addiction treatment. Many people are introduced to it in residential treatment and decide to continue after because they get so much out of it. Whatever the case may be for you, getting help for addiction is an important step toward healing.

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