Cognitive Behavioral Therapy for Drug & Alcohol Addiction

There are several types of evidence-based therapies that can be used to treat drug and alcohol addiction. One of these therapies is cognitive-behavioral therapy, or CBT.

CBT is by far the most researched type of psychotherapy and has a solid body of evidence supporting its effectiveness in the treatment of a variety of different health conditions, including substance use disorder.¹ For these and other reasons, CBT is often viewed as the gold-standard of psychological treatment.¹

In this article, we will discuss what CBT is, what conditions it can treat, and how it works. We will also highlight the benefits of this type of therapy in treating substance use disorders and share ways to find treatment.

What is Cognitive-Behavioral Therapy (CBT)?

CBT is an umbrella term used to describe short-term, goal-oriented psychosocial therapies that are rooted in the theory that a person’s thoughts, emotions, and behaviors are all interconnected.^2,3 Specifically, CBT supports the notion that a person’s patterns of thinking shape their emotions and behaviors. CBT works by helping individuals alter negative thought patterns in an effort to modify maladaptive behaviors and unhealthy emotions.²

CBT is built on concepts of rational emotive behavior therapy (REBT), the first model of psychotherapy to present emotional disturbance as a result of dysfunctional thinking.³ REBT was developed by psychologist Albert Ellis, partly in reaction to psychoanalysis, which Ellis thought was untargeted and too slow to bring about positive change for patients.³Refining this, CBT was developed in the the 1960’s by psychiatrist Aaron T. Beck, who theorized that individuals have three levels of cognition, or ways of thinking.² These include the following:²

• Core beliefs ­– Deeply held beliefs one has about themselves, others, and the world (e.g., “I will always be rejected” or “I have nothing to offer”)
• Dysfunctional assumptions – Unrealistic, rigid, and ultimately unhelpful assumptions that people accept as a way of life (e.g., “If I am not in control, something bad will happen” or “If someone criticizes me, it means I am no good.”)
• Negative automatic thoughts – Thoughts that involuntarily occur in response to certain situations (e.g., “I am stupid” or “They don’t like me”)

By identifying problematic cognitions such as these, a person can work with a therapist to challenge the validity of their thinking patterns and put in place positive changes that can help reduce symptoms of the condition they are experiencing and improve overall functioning.⁴

What Can CBT Treat?

Cognitive-behavioral therapy has been used effectively to treat a wide range of conditions, including:⁴

• Schizophrenia.
• Depression.
• Bipolar disorder.
• Anxiety disorders.
• Body dysmorphic disorder.
• Eating disorders.
• Personality disorders.

Combined behavioral and pharmacological interventions, where they exist, are considered best practice for addiction treatment.⁵ CBT is a first-line behavioral intervention, with a long history of evidence speaking to its effectiveness in treating drug and alcohol addiction.⁵ Other effective evidence-based behavioral interventions, which are sometimes combined with CBT, include contingency management and motivational interviewing.^5,6

How Does Cognitive-Behavioral Therapy Work?

As previously mentioned, CBT is a short-term treatment option, as many individuals begin experiencing improvement in their condition within 8 to 10 sessions.⁷ This form of therapy is a collaborative, one-on-one experience between a patient and a therapist and sessions typically include a specific framework.⁷ This framework often includes the following:^2,7

• Identifying goals – Early on in the beginning of treatment, a patient’s core values are identified and specific goals for their recovery are determined.
• Setting the agenda – At the top of each session, the therapist gathers information regarding what the patient wants to focus on for that session.
• Working on agenda items – Therapists put the agenda in place by collecting information about the chosen point of focus. They work with the patient to pinpoint the negative cognitions that are contributing to unfavorable outcomes.
• Developing an action plan – The patient will be provided with an action plan based on what they accomplished during the session, which can be applied in their daily lives until their next session.
• Measuring progress – Each session will require the patient to measure their progress. This often can involve therapists asking questions regarding mood and functioning, as well as asking clients to complete assessments. This allows the therapist and the patient to develop a shared understanding of what progress has been made.

When sessions are conducted in this (or a similar) manner, CBT can work by providing patients with effective skills that can be practiced both during the session and outside of it.⁷ This allows patients to learn how to rely on themselves (or, in other words, become their own therapist) when it comes to evaluating thoughts and beliefs, as well as developing and maintaining positive relationships, effectively solving problems, and achieving personal goals.⁷

CBT for Addiction Treatment

CBT has a strong evidence base as being an effective treatment for substance use disorder.⁶ CBT skills and techniques that may be implemented in the recovery process can include:^6,8

• Developing strategies to improve upon on self-control.
• Self-monitoring to recognize cravings early on.
• Developing behavioral strategies to avoid triggers.
• Establishing relapse prevention skills.
• Building strong problem-solving skills.
• Exploring positive and negative consequences of continued substance use.

CBT for substance use disorders has shown efficacy on its own, however research has also determined that combining CBT with other psychotherapies and/or pharmacotherapies (i.e., medication) produces more robust treatment outcomes.^5,6

Benefits of Cognitive-Behavioral Therapy

Results and outcomes of treatment with CBT will vary from person to person, but some of the many benefits of CBT for the treatment of SUDs can include:^2,6

• Learning how to recognize destructive thinking patterns.
• Decreasing substance use.
• Increasing abstinence.
• Improving upon interpersonal relationships.
• Developing positive outlets to help managing distress.
• Learning how to change problematic cognitions.

Does Insurance Cover Cognitive-Behavioral Therapy?

Most major insurance providers do offer some level of coverage for psychotherapy sessions that incorporate CBT. However, insurance coverage can vary and can depend on the type of plan that you have. It is always a good idea to speak with your insurance provider to determine your coverage when seeking psychotherapy and treatment for mental and behavioral health issues.

For information on paying for rehab with health insurance, contact us at to speak to one of our admissions navigators.

CBT and Addiction Treatment in Orange County

If you or a loved one are struggling with substance use, consider Laguna Treatment Center’s Orange County rehab center. Located in sunny California, Laguna offers multiple levels of care of addiction rehab for substance use disorders, therefore you can choose the type of addiction therapy that is right for you.

To find out more information and begin the rehab admissions process, contact our admissions navigators today. We can answer your questions about paying for rehab, what to expect in treatment, and how to choose the options and amenities that best suit your needs.

Get started on your recovery right now and have your insurance verified with us. Simply fill out this secure online and get results in minutes.