People’s thoughts and behaviors are often at the root of their addictions. One of the first steps of overcoming addiction is addressing your thought patterns, beliefs and values and understanding how they influence your addictive behaviors. Once you change your thoughts, beliefs and values to something more positive, your behaviors should follow suit.
Cognitive behavioral therapy (CBT) aims to do just that. As an evidence-based therapy, CBT is an effective way to challenge your current mindset and bring about positive change. Learn more about CBT and our CBT program in this article.
CBT is a popular form of psychotherapy that provides structure to patients and focuses on developing goals. Additionally, CBT identifies a person’s negative thoughts, feelings and beliefs about themselves to change their behaviors. The central premise of CBT is that a person’s thoughts contribute to their behavioral patterns.
CBT aims to recognize that, most times, our negative thoughts are not an accurate perception of reality. In many cases, a person’s negative thoughts or beliefs are driven by stress, anxiety and other outside influences but don’t accurately reflect what’s happening. As a result, a person may exhibit negative behaviors, contributing to a vicious cycle of negative thought patterns and behaviors.
People struggling with conditions that CBT commonly treats often experience negative thinking patterns known as cognitive distortions or thinking traps. There are 12 common thinking traps. Some of the most common can look like:
Generally, CBT views negative thoughts, beliefs and behaviors as something that’s learned, meaning that you can unlearn or change them to improve your well-being. One of the main differences between CBT and other forms of psychotherapy is that it’s concerned with present feelings and behaviors as opposed to life history or past traumas. These topics may come up in CBT, but they’re not the primary focus since CBT aims to change current behaviors rather than reflect on past behaviors.
Ideally, CBT therapy techniques will help you address your current thoughts and understand how they influence your actions. In learning how to adopt more positive or appropriate thinking patterns, you can start to shift your behavior as well and respond appropriately in the moment. Improving your response to problems will enhance your well-being and help you focus on the reality of the situation rather than solely on the negatives.
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CBT is an effective cognitive therapy treatment approach, especially when combined with medications to help substance misuse and mental health conditions. CBT can have many benefits for someone in substance use and mental health treatment programs, including:
CBT is a valuable therapeutic tool that can treat various substance use and mental health disorders, offering relief to people in many treatment programs. Since CBT addresses negative thought patterns, it can help people alter their behaviors that contribute to or worsen these conditions.
CBT is most useful in treating:
With some modifications, traditional CBT can also help treat obsessive-compulsive disorder (OCD), borderline personality disorder and post-traumatic stress disorder (PTSD). CBT can also be combined with various medications to help people adhere to their medications and develop habit-forming behaviors. People of all ages can benefit from CBT, whether children or adults.
CBT has also been known to treat nonpsychological conditions like insomnia and other life challenges, such as:
These life challenges can contribute to substance use and mental health issues. Someone who feels stressed at work, experiences relationship problems or is trying to cope with grief may experience worsening mental health symptoms or turn to substances to manage their uncomfortable feelings. CBT can help you address these issues alongside your substance use and mental health disorders, improving your thoughts, behaviors, emotions and overall well-being.
Seeking out therapy is an individualized choice that requires a willingness to change, transparency and long-term commitment. If you have long-standing negative behavior patterns, especially regarding psychological conditions like substance use and mental health disorders, it may be time to seek out CBT. Signs that could indicate it’s time to seek CBT due to substance use and mental health issues include:
Therapists can help you address your negative thoughts and beliefs related to addiction and mental health to shift your behaviors. For example, you may rely on substances when you get stressed at work or experience relationship troubles that make you anxious, believing that it’s your only way to cope with these challenging situations. Your therapist can help you understand why this thought pattern contributes to your addiction and create healthy coping mechanisms so you can handle these situations more positively.
Substance use and mental health challenges will be addressed in many cases as part of a dual diagnosis program, as these two conditions often contribute to one another. CBT can help you find relief and improve your quality of life if you’re struggling with addiction and mental health conditions.
In many forms of therapy, a therapist will focus on past events to help your deal with your trauma or challenging experiences. What makes CBT different is that it solely focuses on current issues and emotions. While a CBT professional may start by asking about your family and personal history to understand you as a person better, sessions will quickly shift towards current thoughts and behaviors to address present issues.
Most CBT sessions occur one-on-one to help you address your specific thoughts, emotions and behaviors. However, you may also participate in group therapy with others who share similar experiences. Group therapy will help you meet people who are going through the same thing and help you build a support network that you can rely on for accountability.
Depending on your needs, CBT sessions can be short-term, but some people engage with a therapist for up to 20 weeks. If you’re participating in CBT as part of a substance use treatment program, you’ll engage in therapy for the duration of your treatment. However, some people choose to continue therapy after seeking additional help. Inpatient treatment programs can range from 30 to 90 days, while outpatient programs tend to last for a few weeks, though some people may choose to stay in an outpatient program longer if they feel they need it.
In CBT, you can also expect to set measurable goals. For example, you may aim to reach out to your friends or family members more often when you feel stressed or anxious rather than turning to substances. Your therapist will help support you and focus on ways you can achieve this goal to alter negative behaviors.
Additionally, many CBT programs come with homework. Your therapist may give you tasks or exercises to help you work through challenges independently, allowing you to keep track of your progress and alter your thought patterns or behaviors as they happen. For example, your therapist may have you keep a journal to monitor your progress and thought patterns. They may send you home with mindfulness and relaxation exercises to help keep you grounded in the present rather than getting caught up in unrealistic thought patterns or negative behaviors to cope with challenging situations.
Remember that CBT will look a little different for everyone. While you might have similar behaviors as someone else, you may have entirely different thought processes that lead up to these behaviors. CBT helps you address your specific thoughts, beliefs and behaviors to help improve your quality of life.
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Generally, the process of CBT is the same across the board, but your therapist may alter the program to suit your individual needs. Here are the basic steps of CBT to help you gain a better understanding of what you can expect when you go to your sessions:
When you go in for your first session, your therapist will have you explain what’s going on in your life to understand the underlying issue better. For example, if you’re struggling with a substance use disorder, your therapist may have you talk about any symptoms you’re experiencing related to substance use or co-occurring mental health conditions. They’ll also have you discuss any challenges in your personal life and voice any concerns you may have, such as relationship or work issues resulting from your behaviors.
It is always beneficial to both you and your therapist if you are honest about your life experiences and what brought you into therapy. Whether that be past or present substance use or mental health diagnoses or struggles, your therapist is there to support the changes to your life that you wish to make. When you’re honest and forthcoming about your current issues, setting realistic goals throughout your therapy will also be easier to help you break problematic habits and behaviors.
Next, your therapist may ask you questions to help guide the sessions and better understand the deeper problem. For example, they may ask questions about life experiences that make you anxious or upset. They’ll likely also ask about fears, phobias, thoughts and feelings to understand what’s contributing to problematic behaviors.
Using the example of substance use, your therapist might ask if your addiction is interfering with your work or social life. Once they’ve determined what events or thought patterns are contributing to your substance misuse, they’ll ask about any previous treatments you’ve had for the same condition and what you’d like to achieve through CBT.
Many sessions in CBT will be question-and-answer, helping you gain a thorough understanding of how you respond to challenging situations. For example, your therapist may ask you how you react when you get stressed at work, noting that your first option may be a tendency to use alcohol or drugs to cope with these feelings or forget about them entirely.
Your therapist will work with you to help you identify unhealthy beliefs, emotions or behaviors that contribute to your substance use. You’ll break down your problems into separate parts, making them easier to understand and manage. You’ll analyze your behaviors and beliefs with your therapist, and they’ll help you determine which ones are unhelpful and unrealistic and how they affect you. As you work through your problems, your therapist may ask you to keep a journal to track negative or triggering situations and how you respond to them, making it easier to identify problematic thought patterns, beliefs and behaviors in your life.
Finally, your therapist will help you change your thinking to help alter your emotions, thoughts and problematic behavior. For example, perhaps stress or critiques at work make you feel anxious or trigger a thought distortion that contributes to your substance use. In that case, your therapist will help you change your thought patterns to be more realistic.
Rather than viewing work critiques as a reflection of your value as a person or a sign that you’re going to be fired, you can work with your therapist to consider these critiques as ways to improve yourself and realize that feedback in the workplace is common. Over time, your negative thoughts will lessen, and you’ll respond to challenging situations with a more positive mindset and improved behaviors that accurately reflect your values and beliefs.
Once you make these mindset shifts in therapy, your therapist may ask you to practice these changes in your daily life, which can include:
Your therapist will likely also teach you coping skills so you can change your thinking, emotions and behaviors when they happen outside of your sessions. Using the example above, your therapist may have you outline alternatives you can use when you feel anxious at work. These alternatives may include keeping a journal of your achievements, talking with a supportive friend or taking breaks to enjoy your hobbies, such as reading, music or art.
Remember that these steps won’t occur in a single therapy session. You’ll need to meet with your therapist regularly to progress toward your goals. You may often go back to previous steps to address new issues during your sessions.
For example, you may be working with your therapist to adjust your thought patterns related to work that contribute to substance misuse. However, you may notice later that you also respond to tension in your relationships with additional substance use. As new problems appear, you’ll circle back through some steps to address these specific issues, such as recognizing the thoughts that make you respond in particular ways during these challenging situations. You’ll adjust your thought patterns, even if you’ve already gone through these steps for previous problems.
If you’ve never participated in a CBT program before or are entering a new one, you may have some lingering questions. Here are the answers to some of the most common questions to help you understand CBT and what to expect.
Various laws protect the information that you share with your therapist. If you share information about your past or current struggles you’re going through, your therapist cannot share this information without your consent unless you or someone else is at risk for serious harm.
While it can be uncomfortable to be vulnerable with someone else, being honest and upfront with your therapist about your challenges is the best way to get the help you need. Therapists need all the information to create an accurate and customized plan that addresses your unique circumstances. It’s all right if you feel like you need to warm up to your therapist at first before sharing the more intimate details of your personal life, but remember that they’re there without judgment to help you find relief and improve your quality of life.
Individual sessions can last anywhere between 30 minutes to one hour. Your initial evaluation sessions may be slightly longer so your therapist can gather all the necessary information.
Group sessions can vary based on the size and what’s being discussed that day. These sessions often give everyone a chance to talk if they want to, so they can last anywhere between one to two hours.
If you’re participating in addiction and mental health treatment that includes CBT, then the Mental Health and Addiction Equity Act has you covered. This act requires insurance providers to provide the same level of coverage for substance use and mental health conditions as it does for physical ailments.
As long as you have some insurance, you’ll have coverage for your substance use, mental health and CBT programs. If your insurance coverage for physical conditions is limited, your substance use and mental health coverage will also be limited, affecting your access to CBT. However, a good rule of thumb is that if you have insurance, you’ll at least have some coverage for your substance use and mental health services, which often include CBT programs. Even if your coverage is limited, it can save you from paying a significant amount out-of-pocket for treatment.
If you’re seeking treatment for substance use and CBT is part of your treatment program, you can also expect to participate in other forms of treatment to help improve your well-being. For example, you may participate in a medication-assisted program or additional therapies, such as acceptance and commitment therapy (ACT) or dialectical behavior therapy (DBT).
CBT and other treatments can help you address your needs and find relief from various conditions sooner. Well-rounded treatment will also give you the skills you need to be successful once you’ve completed your program.
CBT can help you change your way of thinking, allowing you to make rational and positive decisions that can significantly improve your quality of life. Gateway Foundation specializes in treating substance use disorders and underlying mental health conditions using treatments and therapies such as CBT.
Our CBT treatment program is designed to help you change your thoughts and behavioral patterns related to addiction to improve your life. We’ll also teach you the coping skills you need to handle challenging situations after completing treatment. Contact us today to learn more about how we can help you get your life back on track and find a CBT therapy program near you!
