What is Cognitive Behavioral Therapy?

Cognitive behavioral therapy, also known as CBT, is one of the most effective treatment methods for addiction recovery. Many patients can benefit from cognitive behavioral therapy because it addresses unhelpful thinking and stressful situations. If you or a loved one are embarking on the road to recovery, take a closer look at how cognitive behavioral therapy works and how it can help.

Defining Cognitive Behavioral Therapy

Cognitive behavioral therapy is a combination of psychotherapy and behavioral therapy. All CBT sessions are held in a private, one-on-one environment between patient and therapist.

Typically, cognitive behavioral therapy is conducted just one time a week. Sessions are often just under an hour long. This might seem short, but it is intensive.

CBT is also unique because it is not designed to be ongoing. Patients typically don’t participate in cognitive behavioral therapy for a lifetime. On average, cognitive behavioral therapy lasts for six to eight months. At that point, any progress that can be made has likely already been made.

In the 1960s, cognitive behavioral therapy was developed by a psychiatrist named Aaron Beck. He was the first to notice that during therapy, many patients were having an internal dialogue. Most of this internal dialogue was kept private by patients.

One way to look at cognitive behavioral therapy is a technique that directly addresses that internal dialogue. If the inner voice in a patient is expressing negative thoughts that could impact addiction recovery, then it has to be modified. Cognitive behavioral therapy seeks to change negative thoughts into positive ones. This can help with addiction as well as other conditions such as depression, paranoia, and anxiety.

CBT and Dysfunctional Assumption

One of the focuses of cognitive behavioral therapy is dysfunctional assumption. This is a pattern of thinking that can be harmless but often becomes a problem for those with addiction.

Dysfunctional assumption is a foregone conclusion without any evidence. For example, a person in rehab might think, “I’m an addict. I can never succeed in life.” This is absolutely incorrect, and it can hold people back from accomplishing their goals.

If a person believes something, even if it is wrong, then it will be hard to overcome. Many patients who are in addiction treatment don’t say these dysfunctional assumptions out loud, which makes it even harder to address.

In cognitive behavioral therapy, therapists use techniques to encourage patients to reveal their dysfunctional assumptions. Then, they can be systematically debunked. This can help patients challenge their incorrect and harmful patterns of thinking. In the example above, the patient can start to consider a successful life, working harder to accomplish great things in the future.

Addressing Automatic Thoughts

Cognitive behavioral therapy will also focus on automatic thoughts. Once again, these thoughts are part of a dysfunctional thought pattern. Often, these patterns develop in childhood, and addiction reinforces them. During recovery, however, CBT can reveal that automatic thoughts are often false.

An automatic thought might be, “No one wants to help me because I’m an addict.” Or, it could be, “I’m a failure, and nothing can change that.” These thoughts can be repeated so often that patients genuinely believe they are true.

During cognitive behavioral therapy, therapists will work hard with patients to dismantle automatic thoughts. They might mention family members as proof of support and love. They can highlight the value of a patient, hammering in facts that deny the automatic thoughts. This can be tough for patient and therapist, but it is incredibly beneficial to be freed from the shackles of negative, automatic thoughts.

Developing Coping Skills in Rehab and Beyond

Arguably the biggest threat to a patient’s sobriety is relapsing. More than half of all individuals who receive some form of addiction treatment will eventually relapse and fall back into addictive patterns. Many things can lead to relapse, including negative thought patterns and stress. Cognitive behavioral therapy may be able to prevent relapse by helping patients develop coping skills.

Coping skills are unique to each individual patient. What works for one person may not necessarily work for another. That’s why individual therapy is so critical.

During CBT, a therapist or psychiatrist can bring up examples of stressful situations that could spark a relapse. Patients will need to imagine themselves in these difficult situations. Examples might include being embarrassed in a social setting, being turned down for a job opening or going through a romantic breakup.

Then, patients can verbally discuss how to respond in a healthy way. Coming up with alternatives to relapse means that if these stressful situations really happen, there will be a plan in place. Instead of drinking, patients can call their addiction sponsor. Instead of using drugs, they can hit the gym to relieve stress in a much healthier way.

Eliminating Black and White Thinking

One of the hallmarks of addiction is black and white thinking. This is an all-or-nothing mentality, and it can be a major obstacle on the road to recovery. No patient should be expected to be perfect at all times, and there is plenty of middle ground between perfection and failure. Cognitive behavioral therapy can address this dangerous way of thinking.

The biggest problem with black and white thinking is that it can cause a relapse. Just because you make a small mistake, it doesn’t mean you should throw all your progress away. CBT can teach patients how to recognize a mistake, move on, and continue toward recovery.

What to Expect From a CBT Session

Patients should expect their first cognitive behavioral session to take around 60 minutes. It will be one-on-one, and it will start with a brief evaluation. Patients will be asked what they want to accomplish, and any mental health issues can be identified.

You should expect to confront serious issues during cognitive behavioral therapy. However, keep in mind that the end goal is always happiness, confidence, and strength.

Cognitive behavioral therapy is a popular and effective means of addiction treatment. When combined with other treatment methods, it can pave the way for a lifetime of sobriety and health.