Rehab Treatment Therapies Cognitive Behavioural

Cognitive behavioural therapy, or CBT, is one of the most common therapies used in rehab treatment around the world. It works on the straightforward idea that the way you think affects how you feel, and how you feel affects what you do. CBT is an incredibly adaptable therapy with uses for a wide range of conditions, including addiction recovery. CBT for addiction gives you practical tools to deal with all the situations that make you want to drink, use drugs, or engage in addictive behaviours.

cbt therapy session

What is cognitive behavioural therapy?

CBT is a type of talking therapy that examines the direct link between our thoughts, emotions, and actions. In CBT treatment for substance abuse and harmful behaviours, this means learning to identify the thoughts that lead to drinking, drug use, gambling, gaming, and conditions like eating disorders. These thoughts can be things like “I can’t cope without a drink”, “One bet won’t hurt”, or “I’ve already messed up today, so I might as well keep going.”

Once you can spot these thoughts, you learn to ask questions, like “Is it really true I can’t cope?”, “When was the last time I only placed one bet?” or “Does one slip up mean all progress has gone out the window?” Through this careful process, you develop new ways of responding whenever substance cravings or difficult situations arise in your life.

Why does CBT work for addiction?

Addiction creates patterns and associations in your brain, so you link certain feelings, places, or people with substance use or compulsive behaviour. For example, if you always drank when you felt anxious, or gambled when you felt stressed, your brain has learned “anxiety = alcohol” or “stress = gambling.” CBT teaches you to notice the feeling, recognise the thought “I need to drink” or “I need to place a bet,” and choose a different response. This can include breathing techniques, calling your sponsor, counting slowly to ten, or simply reminding yourself that the feeling will pass if you don’t act on it.

CBT therapy techniques also help you identify situations that are dangerous for your recovery before you’re in them. If you know that Friday nights with certain friends always lead to drinking, or that having your phone nearby all the time triggers compulsive buying, you can plan ahead.

CBT for addiction also addresses thoughts that aren’t true or helpful to you and which fuel the cycle. These include thinking in extremes (“I’m either completely sober or completely wasted”), imagining the worst will happen (“If I don’t use, I will feel terrible forever”), and downplaying the problem (“It’s just a few drinks, it’s not that bad”). Learning to catch and challenge these thoughts can nip them in the bud before they derail your recovery.

How is CBT delivered in rehab?

CBT for substance abuse and addiction can be delivered in several different formats depending on different rehab programmes and what works best for you. Most alcohol and drug rehab centres offer a combination of approaches, along with medical detox and other therapies. This approach tackles drug and alcohol addiction from every direction. Some of the most effective ways of taking part in CBT therapy include:

Individual CBT sessions
In one-on-one CBT counselling, you work privately with a therapist who focuses on your specific triggers and thought patterns. Your therapist will teach you techniques like keeping track of your thoughts, where you write down a difficult situation, the thought it triggered, how that thought made you feel, and what happened. You will then start to notice what keeps happening and learn to think differently.
Group CBT therapy
This is where you learn CBT alongside other people in recovery, and they are a great source of shared wisdom. There are various ways a group session can be planned, but your therapist may teach specific CBT therapy techniques, then have everyone discuss how they would apply them. Hearing how someone else challenges their thinking can help you question your own, and needing to report back on your progress can ensure you practice between sessions.
Short-term structured programmes
Unlike some therapies that continue indefinitely, CBT for addiction is usually delivered over a set number of sessions. This structure works well in residential drug or alcohol rehab where your entire stay might be 28 days or twelve weeks. This limited time gives you clear goals to work towards and a set of skills that will serve you after you leave treatment.

cbt one to one therapy

Benefits of CBT in addiction treatment

There is wide ranging evidence showing that CBT can help reduce relapse rates even months and years after treatment ends.

The practical nature of CBT therapy means you walk away with ready-to-use techniques you can apply immediately. When drug or alcohol cravings hit at 2am and you can’t call your therapist, CBT gives you a toolbox of proven responses so you can get through them.

CBT treatment also helps with the other mental health issues that often exist alongside addiction. Depression, anxiety, and trauma all involve damaging thoughts that exacerbate addictive behaviours. Learning to challenge these thoughts can greatly improve your overall wellbeing, making it easier to stay away from substances and compulsive behaviours.

Other therapies used to treat addiction

As explained above, the substance and behavioural rehab programmes with the best results combine CBT with a range of other approaches. Here are some of the most common therapies used alongside CBT:

Dialectical behaviour therapy (DBT)
DBT is similar to CBT but adds extra focus on relationships improvements and handling emotions when they get too much. It teaches mindfulness skills to help you stay present rather than reacting impulsively. DBT works particularly well if you struggle with managing your emotions or have a complex dual diagnosis like borderline personality disorder and drug addiction.
12-step programmes
While CBT gives you thinking tools, the 12 steps provide a spiritual approach and support from others like you. The two approaches complement each other, with CBT helping you manage day-to-day triggers, and the 12 steps addressing deeper issues.
Family therapy
Drug and alcohol addiction affects everyone close to you, but family therapy brings loved ones right into the heart of treatment. Family sessions can work very well alongside individual CBT as you will be able to stay calm when communicating which can help create better relationships. Families can also take part in group CBT together and this can be very powerful for some people in recovery.

Getting the right support

If you are looking for the right treatment and want to know more about CBT for addiction, Recovery.org can tell you more. CBT is one of the most effective recovery therapies, so choosing a rehab centre with the right CBT programme is a crucial decision. Contact us today, and we will help make that decision as easy as possible.

Frequently Asked Questions

What is CBT in recovery?
CBT in recovery is a structured therapy that helps you identify and change the thoughts and behaviours keeping you addicted. You will learn to recognise triggers, challenge damaging thoughts, and develop usable, everyday strategies for cravings and relapse prevention.
What are the seven pillars of CBT?
The “seven pillars” describe certain challenges and aims of CBT: clarity, coherence, cohesion, competence, convenience, comprehensiveness, and connectivity. These are not strict principles, as CBT for addiction is based on core ideas like the connection between thoughts, feelings, and behaviours, the importance of challenging damaging thoughts, and how to develop usable coping strategies. Different CBT practitioners may structure therapy differently, but these core ideas are universal.
How is CBT used for addiction?
CBT for addiction helps you identify the thoughts and situations that trigger substance use or compulsive behaviour. You learn to recognise patterns like “I can’t cope without drugs or alcohol” and challenge them with evidence and alternative thinking. Your therapist teaches specific techniques for resisting or distracting yourself from cravings, getting through situations that are dangerous for your recovery, and preventing relapse long-term.