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CBT Therapy for Addiction, Efficacy & Techniques

What is CBT therapy?

CBT Therapy For Addiction is a classification of mental health counseling founded in the 1960s by Dr. Aaron T. Beck and can be a really effective treatment for people suffering from substance abuse disorder. Cognitive-behavioral therapy helps people address problematic thoughts and feelings to overcome addiction.

As stated by the National Institute on Drug Abuse, Cognitive-Behavioral Therapy (CBT) was developed as a method to prevent relapse when treating problem drinking, and later it was adapted for cocaine-addicted individuals. Cognitive-behavioral strategies are based on the theory that in the development of maladaptive behavioral patterns like substance abuse, learning processes play a critical role. Individuals in CBT learn to identify and correct problematic behaviors by applying a range of different skills that can be used to stop drug abuse, CBT therapy for addiction address a range of other problems that often co-occur with it.

A central element of CBT is anticipating likely problems and enhancing patients’ self-control by helping them develop effective coping strategies. CBT therapy for addiction has specific techniques include exploring the positive and negative consequences of continued drug use, self-monitoring to recognize cravings early and identify situations that might put one at risk for use, and developing strategies for coping with cravings and avoiding those high-risk situations.

Research indicates that the skills individuals learn through cognitive-behavioral approaches remain after the completion of treatment. Current research focuses on how to produce even more powerful effects by combining CBT therapy for addiction with medications for drug abuse and with other types of behavioral therapies. A computer-based CBT system has also been developed and has been shown to be effective in helping reduce drug use following standard drug abuse treatment. [1]

CBT Therapy for Addiction
CBT therapy for addiction: A central element of CBT is anticipating likely problems and enhancing patients’ self-control by helping them develop effective coping strategies.

Understanding CBT Therapy for Addiction

According to, CBT therapy for addiction is used widely today in different treatments. CBT teaches recovering addicts to find connections between their thoughts, feelings, and actions and increases awareness of how these things impact recovery. [2]

Alongside addiction, CBT also treats co-occurring disorders such as:

  • Obsessive Compulsive Disorder (OCD)
  • Eating Disorders
  • Post-Traumatic Stress Disorder (PTSD)

As the American Addiction Centers state in the piece ‘Cognitive Behavioral Therapy Techniques and Addiction Treatment’, it’s common for individuals struggling with substance use disorder to have destructive, negative thinking. Not recognizing these thought patterns are harmful, they seek treatment for depression or other external influences. Since cognition affects our wellbeing, changing harmful thought patterns is essential. 

CBT Therapy addresses harmful thought patterns, which help clients recognize their ability to practice alternative ways of thinking and regulate distressing emotions and harmful behavior. As a research-based treatment modality, CBT is an effective treatment for substance abuse, eating disorders, and specific mental health diagnoses. An active therapeutic modality, CBT is present-oriented, problem-focused, and goal-directed, which may provide the following benefits:

  • CBT explores the client’s patterns of behavior leading to self-destructive actions and beliefs that direct these thoughts
  • CBT allows clients and therapists to work together in a therapeutic relationship to identify harmful thought patterns and actively seek alternate thinking
  • CBT sessions are augmented with homework outside of sessions using AAC’s dual diagnosis curriculum workbook, Embracing Change: Recovery for Life
  • CBT can be provided in group and individual therapy
  • CBT skills are useful, practical and helpful strategies that can be incorporated into the client’s everyday life
  • CBT helps clients formulate coping strategies to handle potential stressors or difficulties following addiction treatment [3]

Efficacy of CBT Therapy for Addiction

Because CBT takes on some of the negative or distorted thinking, it tackles cognition tendencies that are deeply ingrained in individuals struggling with addiction. By assisting clients to recognize the thinking that drives their addiction behavior, it is an effective treatment modality for substance abuse, binge eating disorders, and specific mental health diagnoses.

For addiction treatment, CBT is effective because it is highly focused compared to other therapeutic modalities; a course of CBT sessions is relatively short-term in nature. Since addiction treatment programs are normally offered in timeframes lasting 30-days, 45-days or 90-days, CBT can quickly focus on the client’s maladaptive substance use to help develop alternative behavior skills as part of his/her integrated treatment plan. [3]

CBT Therapy for Addiction
Because CBT takes on some of the negative or distorted thinking, it tackles cognition tendencies that are deeply ingrained in individuals struggling with addiction.

Cognitive-behavioral therapy has a high range of efficacy when used as a treatment for substance use disorder. According to the scientific piece ‘Cognitive-Behavioral Therapy for Substance Use Disorders’, evidence from numerous large-scale trials and quantitative reviews supports the efficacy of CBT for alcohol and drug use disorders. “For example, our group conducted a meta-analytic review of CBT for drug abuse and dependence including 34 randomized controlled trials (with 2,340 patients treated) and found an overall effect size in the moderate range, with effect sizes ranging from small to large.

Larger treatment effect sizes were found for the treatment of cannabis, followed by treatments for cocaine, opioids, and, with the smallest effect sizes, poly-substance dependence. Of individual treatment types, there was some evidence for greater effect sizes for contingency management approaches (see below) relative to relapse prevention or other cognitive-behavioral treatments”. [4] 

Individual and Group CBT Therapy for Addiction

CBT for Substance Use Disorders (SUDs) encompasses a variety of interventions that emphasize different targets. Below, researchers review individual and group treatments including motivational interventions, contingency management strategies, and Relapse Prevention. [4]

Motivational interventions: At the outset of considering treatment, motivation for treatment and the likelihood of treatment adherence needs to be considered. To address motivational barriers to change, motivational enhancement techniques have been created and tested. Motivational Interviewing is an approach based on targeting ambivalence toward behavior change relative to drug and alcohol use, with subsequent application to motivation and adherence to a wide variety of other disorders and behaviors, including increasing adherence to CBT for anxiety disorders.

Contingency management: As treatment is initiated, a primary challenge is countering the robust reinforcing effects of the drug. Contingency management (CM) approaches are grounded in operant learning theory and involve the administration of a non-drug reinforcer (e.g., vouchers for goods) following demonstration of abstinence from substances.

Relapse Prevention and other treatments: Another well-researched cognitive-behavioral approach to drug abuse has emphasized a functional analysis of cues for drug use and the systematic training of alternative responses to these cues. This approach, termed Relapse Prevention (RP) focuses on the identification and prevention of high-risk situations (e.g., favorite bars, friends who also use) in which a patient may be more likely to engage in substance use. Techniques of RP include challenging the patient’s expectation of perceived positive effects of use and providing psychoeducation to help the patient make a more informed choice in the threatening situation.

Couples and Family Treatments: Although substance abuse treatment often occurs in an individual or group format, the disorder itself has strong ties to the patient’s social environment. Accordingly, several promising treatments have been developed, which utilize the support of the partner, family, and community to aid the patient in achieving abstinence. [4]

How CBT Therapy for Addiction Works?

Automatic negative thoughts are often a root cause of depression and anxiety disorders, which are common co-occurring disorders with addiction. This means automatic thoughts can make someone more likely to abuse drugs and alcohol as well. CBT helps patients overcome drug addiction and alcoholism by:

  • Helping to dismiss false beliefs and insecurities that lead to substance abuse
  • Providing self-help tools to better their moods
  • Teaching effective communication skills

Triggers — situations that “trigger” cravings throughout the day — keep many addicted people from getting sober. Cognitive-behavioral therapy helps recovering addicts deal with triggers in three key ways, according to the National Institute on Drug Abuse. [1]

Skills for Managing Triggers

  • Recognize: Identify which circumstances lead to using drugs or drinking.
  • Avoid: Remove yourself from trigger situations whenever possible or appropriate.
  • Cope: Use CBT techniques to address and alleviate emotions and thoughts that lead to substance abuse.

Cognitive-behavioral therapy techniques can be practiced outside the therapist’s office. [2]

Techniques of CBT Therapy for Addiction

Cognitive-behavioral therapists use specific exercises to help addiction recovery. Examples of CBT techniques used in addiction treatment include:

Thought Records: Recovering addicts examine automatic negative thoughts and look for objective evidence supporting and disproving those thoughts. They list evidence for and against their automatic thoughts to compare and contrast. The goal is to help them think more balanced and less harsh thoughts by critically evaluating what they’re thinking.

Behavioral Experiments: These exercises contrast negative thoughts against positive ones to see which is more effective in changing behavior. Some people respond better to self-kindness and others to self-criticism. Behavioral experiments are all about figuring out what works best for the individual.

Imagery Based Exposure: In this exercise, recovering addicts think of a memory that produces powerful negative feelings. They take note of every sight, sound, emotion, thought, and impulse at that moment. By frequently revisiting painful memories, the addicted person can reduce the anxiety caused by them over time.

Pleasant Activity Schedule: This technique involves making a weekly list of healthy, fun activities to break up daily routines. These tasks should be simple and easy to perform while encouraging positive emotions. Scheduling these pleasant activities helps reduce negative automatic thoughts and the subsequent need to use drugs or drink. [2]

Reclaim your life from Addiction with CBT

Substance abuse disorder is a condition that can cause major health, social, and economic problems that should not be taken lightly. We Level Up Treatment Center can provide you, or someone you love, CBT Therapy For Addiction with professional and safe care. Feel free to call us to speak with one of our counselors. We can inform you about this condition by giving you relevant information. Our specialists know what you are going through. Please know that each call is private and confidential.


[1] NIDA. 2020, June 1. Cognitive-Behavioral Therapy (Alcohol, Marijuana, Cocaine, Methamphetamine, Nicotine) – National Institute on Drug Abuse (

[2] ‘Cognitive Behavioral Therapy’ – (

[3] ‘Cognitive Behavioral Therapy Techniques and Addiction Treatment’ – American Addiction Centers (

[4] McHugh, R. K., Hearon, B. A., & Otto, M. W. (2010). Cognitive behavioral therapy for substance use disorders. The Psychiatric clinics of North America, 33(3), 511–525. – U.S. National Library of Medicine (