Addiction Treatment and Mental Health Blog

The team at Fifth Avenue Psychiatry aims to help both adults and adolescents with substance abuse and mental health issues.

Cognitive Behavior Therapy (CBT) for Addiction and Alcoholism

By Tracey Basset, PsyD

Making the decision to seek help for a substance use problem is challenging enough. On top of that, for a lot of people, they face the challenge of choosing where to go, who to see, and what type of therapy will benefit them most. This can be a very confusing and daunting process.

My aim for this post is to provide some useful information about the benefits of one type of therapy, my favorite type of addiction therapy, Cognitive Behavioral Therapy (CBT).

What is Cognitive Behavior Therapy?

CBT is based on the notion that the way we think influences how we feel and, subsequently, how we behave. Think of it like a domino effect—something happens, you form a thought or belief about that event, that thought creates a feeling, and that feeling creates an action.

For example, if you try to reach out to a friend or family member and they do not have time to see or talk to you, then you might think that you are not important to them, that you are not worthy of their time, or that you are not good enough. That thought can lead to feelings of loneliness, rejection, sadness, or even anger. Those feelings can then lead to the desire to escape, which could ultimately lead to using a substance. Substance use leads to more isolation and less connection, so the cycle starts again and continues to build.

How is CBT Used to Treat Addiction?

In CBT, we explore these triggering events and identify patterns. We explore the thought patterns, or belief systems, and we challenge those patterns that may be problematic.  Some beliefs are true, and we work to problem-solve and change them. Others are not true and are simply believed to be true because they have been ingrained for a very long time. We learn to explore where beliefs come from, and we learn to challenge them.  In CBT, we learn strategies to cope with the uncomfortable feelings and strategies to help reduce the likelihood that certain feelings will trigger substance use.  This is just one example of how CBT can play out in therapy; There are dozens more.

The Benefits of CBT

CBT can be a great therapy for individuals struggling with substance use along with co-occurring anxiety and/or depression because it provides tools, strategies, and a roadmap for how to gain control when you feel out of control. If you are someone that struggles with anxiety and/or depression in addition to substance use, it may feel like there are too many things to tackle, and you may even feel stuck, helpless or hopeless. However, CBT works on exploring, challenging, and changing the relationship between symptoms of depression, anxiety and substance use.  Therefore, it is a very practical, effective and efficient approach to tackling co-occurring substance and mental health needs that feel complex in nature.

So, why is CBT my favorite type of therapy?  Because there is a lot of evidence to show that it works. CBT is empirically-based, meaning that there are many research studies that consistently show that it helps individuals to reduce anxiety and depression and successfully address substance use.

In closing, I will leave you with a quote.  It is one that I recently stumbled upon in my personal life, and I instantly connected with it because it just made so much sense to me given my predisposition to think of life through the lens of CBT.  So, despite what you may be going through, and my guess is that it may be something quite challenging since you are here reading this page, the good news is that at any time you can choose to take the steps to change your destiny.

Watch your thoughts; they become words.

Watch your words; they become actions.

Watch your actions; they become habits.

Watch your habits; they become character.

Watch your character; for it becomes your destiny.

– Upanishads

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