What Is Cognitive Behavioral Therapy?

Key Takeaways

• Cognitive behavioral therapy (CBT) is a short-term technique exploring the link between thought patterns and mental illness.
• CBT is used to identify negative emotions and thoughts to understand the root cause of addiction.
• CBT is an effective method of psychotherapy used to treat various mental health problems, including addiction and substance use disorders.
• CBT is a valuable tool that provides techniques and skills to manage negative thoughts linked to addiction.
• CBT can help you identify, avoid, and control cravings.

What is Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is a form of psychological treatment that has proven effective for various mental disorders. It is a short-term therapy technique that explores the link between thought patterns and mental illness.¹

CBT also helps you effectively address challenging situations. It can be a helpful tool in treating mental health disorders such as:¹

• Depression
• Anxiety disorders
• Substance use disorders (SUD)
• Post-traumatic stress disorder (PTSD)
• Eating disorders
• Bipolar disorder
• Schizophrenia

However, you don’t need a mental health condition to benefit from CBT. CBT is useful for helping you manage stressful life situations better.

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CBT Techniques

CBT employs various techniques to help you become more aware of your mental health. The most common techniques in CBT are:

• Cognitive restructuring: A technique that teaches you how to identify irrational thoughts and replace them with realistic, positive statements.
• Exposure therapy: Involves carefully confronting uncomfortable situations to overcome your fears. 
• Behavioral assignments: Assignments designed to monitor negative thoughts, practice relaxation techniques, and incorporate healthy lifestyle changes.
• Problem-solving: Involves learning techniques to improve decision-making and finding alternative solutions when needed.
• Successive approximation: A technique that uses small tasks to help you build confidence for tasks you may find overwhelming or anxiety-inducing.
• Activity scheduling: Specific activities that help you develop positive behaviors and thought patterns, like hobbies, meditation, or journaling.
• Mindfulness practices: Relaxation techniques that help you manage negative or stressful thoughts and anxiety. 

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What Is Cognitive Behavioral Therapy?

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CBT for Substance Abuse

CBT can be an effective tool for treating substance abuse because it addresses the root cause of addiction. Frequently, substance abuse is caused by co-occurring disorders that instill automatic negative thoughts.²

Disorders like anxiety and depression often cause negative thought patterns and behaviors. They can increase the likelihood of developing a SUD.

During CBT, your therapist will encourage you to talk about your thoughts, feelings, and what’s troubling you. As you go through CBT, you’ll learn techniques to address and alleviate feelings that lead to substance abuse.²

CBT for Addiction

CBT can help you overcome drug addiction and alcohol use disorders by:^2,3

• Helping you overcome insecurities that lead to substance abuse
• Providing self-help tools to improve your mood
• Teaching effective communication skills
• Helping you identify, avoid, and manage cravings
• Helping you cope with mental issues in a healthier way
• Building your confidence to tackle overwhelming or stressful situations

Effectiveness and Success Rates

Research has shown that CBT can effectively treat substance use disorders. It has also shown to be effective on its own and with other treatment strategies.²

One study showed that 60% of patients who went through CBT provided clean toxicology screens at 52-week follow-ups.² Another study reported fewer depressive symptoms and improved mental functioning after 6 months.⁴

They also reported fewer drinking days and problematic substance use. Lastly, CBT alone is 50-75% effective for overcoming depression and anxiety.⁵

Co-Occurring Disorders

The coexistence of a mental illness and SUD is known as a co-occurring disorder. If you struggle with a SUD, you are at particular risk for developing one or more mental illnesses.⁶

A co-occurring disorder can be challenging to treat because addiction can worsen mental disorders and vice versa. It’s also tough to determine if the mental illness or the addiction came first.

The most common mental health conditions associated with addiction and substance abuse are:⁶

• Bipolar disorder
• Major depression
• Personality disorders
• Post-traumatic stress disorder (PTSD)
• Anxiety disorders
• Attention deficit hyperactivity disorder (ADHD)

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Pros and Cons of CBT for Addiction

Although CBT is an effective treatment method for mental health problems, it might not suit everyone. People respond to treatment differently, and CBT might not be for you.

Pros of CBT

The advantages of CBT include:⁷

• It can be completed in a relatively short period.
• It can be available in different formats, such as groups, self-help books, and online resources.
• It teaches practical and useful skills for everyday life.
• It encourages self-improvement and healthy choices.
• It can be as effective as medication.
• It can be a helpful alternative if medication hasn’t worked.

Cons of CBT

Some of the disadvantages of CBT you should consider include:⁷

• It requires your full commitment to the process.
• Attending sessions and doing extra work between sessions can be time-consuming.
• It may not be suitable for people with complex mental health needs or learning difficulties.
• It requires you to confront your emotions and anxieties, which may be uncomfortable.

Some critics argue that CBT does not address wider problems that may significantly impact your health and well-being. For example, CBT does not address underlying mental health conditions like an unhappy childhood.

Is CBT Covered by Insurance?

CBT is a form of psychotherapy. If your insurance plan covers psychotherapy or behavioral medicine, it should cover most, if not all, CBT sessions.

The average cost of CBT therapy ranges from $50 to $250 per session. Some therapists may offer sliding scale fees, meaning they'll adjust their fees based on your ability to pay.

Contact your insurance provider to determine your coverage for mental health services. You can also ask them about copays and deductibles.

Can You Get CBT Online?

CBT can be done online. It can be a convenient option for people who travel or prefer the privacy of at-home counseling sessions.

Online therapy also provides a lot of flexibility if you have a hectic schedule. With online CBT treatment, your therapist may write back within the hour or a few times weekly.

Many therapists at BetterHelp offer cognitive behavioral therapy. They’ll be able to teach you valuable skills in managing your negative thought patterns and behaviors.

Other Supplemental Therapies:

Certain treatment options can complement or provide an alternative to CBT if you or a loved one are struggling with SUD. These treatment options include:

• Dialectical behavior therapy (DBT): Focuses on accepting your experiences to identify and change negative thinking patterns.
• Contingency Management: Involves using rewards and incentives for positive reinforcement to promote healthy choices and sobriety.
• Motivational Interviewing: A therapeutic approach designed to help motivate healthy behavior and self-improvement. 
• Group therapy: A form of psychotherapy that includes at least 3-4 participants.
• Dual diagnosis treatment: A treatment program that addresses co-occurring mental health disorders alongside addiction.
• Addiction counseling: Provides counseling, support, and guidance to people with addiction or behavioral disorders.

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