Cognitive Behavioral Therapy (CBT) for Addiction Treatment

If you're struggling with your mental health, therapy can be a very useful tool.

Contact Us At: (888)610-2847

If you’re struggling with your mental health, therapy can be a very useful tool. However, therapy comes in all shapes and sizes, so it is important to find a style that suits your unique needs. Cognitive behavioral therapy (CBT) is an evidence-based and widely used form of psychotherapy that’s helped many people around the world. This therapeutic technique involves identifying and changing problematic thought cycles, and it’s been proven to be effective for issues ranging from social anxiety disorders, schizophrenia, to substance abuse. To see if CBT is right for you, it’s helpful to learn all about what this therapy is and how it works.

What Is Cognitive Behavioral Therapy?

Cognitive behavioral therapy (CBT) is a type of talk therapy where you sit with a trained counselor and discuss your challenges and generally considered short-term therapy. It was developed in the 1970s by Aaron Beck as an attempt to merge behavioral therapies that focused on patients’ actions and cognitive therapies that focused on patients’ beliefs. Beck drew on theories developed by psychologist Albert Ellis, the creator of rational emotive behavior therapy (REBT), among others, to develop an approach that was short-term and goal-oriented, in contrast to the dominant modalities of the time.

CBT is all about recognizing and changing behavioral patterns that are negatively affecting your behavior. The CBT modality begins by finding cognitive distortions. These are negative thought patterns, such as “When I’m stressed, I need a drink,” that encourage patients to behave in unhealthy manners.

A CBT therapist then guides their patients through the process of reconceptualizing these cognitive distortions. Their assistance can help people to reshape their negative patterns and develop healthier mindsets. Along the way, the therapist also helps the patient change their behavior. They can recommend healthy coping methods for dealing with maladaptive thoughts or suggest new behaviors that can help to shift thoughts in a healthier direction.

Uses of Cognitive Behavioral Therapy

CBT is popular because it has so many different applications. A trained therapist can easily adapt the CBT procedure to suit all sorts of situations. One of the most common uses for CBT is managing depression or anxiety. CBT can help people cope with stressful situations in their life or process grief.

People frequently use CBT for substance use disorders as well. CBT for alcohol addiction or drug addiction can be very effective. In these cases, it works because it helps patients discover better ways for managing personal challenges and addiction cravings.

CBT is also useful for a variety of other clinical disorders and can also help manage non-psychological health conditions, such as insomnia and chronic pain. Some potential uses for CBT include treating:

  • Post-traumatic stress disorder
  • Eating disorders
  • Obsessive-compulsive disorders
  • Schizophrenia
  • Phobias

The Pros and Cons of Cognitive Behavioral Therapy

Like any other therapeutic method, CBT has both advantages and disadvantages. Before you try it, there are some things to be aware of.

Benefits of Cognitive Behavioral Therapy

CBT is one of the more structured forms of therapy which means it can be very useful for those who want defined expectations and fast results. Instead of just chatting with people and hoping for the best, there are precise goals to seek and specific steps to take. Compared to other forms of therapy, CBT can provide positive outcomes in just a few weeks.

CBT is so effective because it combines both behavioral and cognitive aspects of therapy. Patients can use it to adjust problematic thoughts, but it also provides real-world skills you can use. These can result in behavioral changes that further help to improve your mental health.

Another perk of CBT is its flexibility. Because it’s a process, not a checklist, it can be adjusted to suit a wide range of mental health problems. This makes it very useful for people with co-occurring mental disorders. For example, if you have both depression and an opioid use disorder, CBT can address both of those issues simultaneously.

Potential Challenges of Cognitive Behavioral Therapy

Despite all of its benefits, CBT isn’t a magical cure. Mental illnesses can also have a physical component that requires medication. Some patients may not be able to focus on CBT until other issues like psychosis are properly managed.

CBT usually works best on willing patients. A person can get a small amount of benefit simply from listening to the therapist, but you don’t get the full effects of CBT unless you actually commit to the process. Consistent therapeutic sessions and an actual commitment to following recommendations are necessary if you want the benefits of CBT.

What to Expect in Cognitive Behavioral Therapy

Since CBT is a type of talk therapy, you can expect to spend your sessions in a comfortable, quiet environment. The therapist will usually sit and chat with you, and you can choose to sit, lie down, or pace around as needed. Typically, CBT consists of weekly sessions that last around 30 minutes to 60 minutes, and the entire process lasts between 12 weeks to 20 weeks. However, there is some variation depending on your needs. For example, if you’re in a rehab center, you might try daily CBT sessions for four weeks. Whatever timeline your healthcare professionals recommend, CBT usually follows these phases.


Every CBT treatment begins by getting to know your therapist. Building a strong relationship and having a therapist who really knows and understands you is essential to the process. In the first few sessions, you can expect to spend some time casually talking with your therapist. You’ll discuss your life, your motivations for starting CBT, and your plans for the future. As the sessions progress, your therapist will probe deeper into your thought process. They will analyze your approach to life and help you recognize maladaptive thought patterns that are causing problems for you.


After your therapist identifies areas to work on, they’ll discuss them with you. You can expect your CBT therapist to highlight ways of thinking that are inaccurate and problematic. The therapist will help guide you through the process of changing how you view and instinctively react to situations. Their guidance will focus on transitioning from negative thoughts to positive ones. For example, if a patient is in rehab, they might feel there’s no point in trying because they believe, “I’ve ruined my life with drug addiction.” The therapist can help the patient reconceptualize that viewpoint and instead realize, “This is my chance to start a new and better life.”

Acquiring Helpful Skills

CBT therapists work with patients to find concrete, behavioral actions related to their new and positive thought patterns. Skill acquisition both helps patients change their behavior and ensures they fully understand the new thoughts they’ve discussed. So if a patient has learned the new viewpoint, “I don’t have to drink when stressed,” the therapist would then suggest other behaviors they could try when stressed out. Usually, this is the phase when patients start to see the benefits of CBT.

Skill Application

As you start to take the skills you’ve learned in therapy into the real world, you’ll continue with CBT sessions. In each session, you’ll discuss how you’ve been applying your new skills and talk about what is and isn’t working. Your therapist will give you support and encouragement, and they’ll also provide a lot of helpful input. You’ll find that a lot of the concepts that seem easy in therapy aren’t as simple in the real world with all of its stress and unpredictability. However, your CBT sessions will help you find approaches that work for you. As you do this, you may find that you no longer automatically reach for your old thought patterns when you encounter challenges.


By the maintenance stage, you’ll be comfortable handling challenges and applying your new skills to your life. However, CBT still requires some additional sessions. The maintenance stage is a great opportunity to talk about the future and ensure you’ve made lasting changes. Though your therapist won’t continue to provide CBT therapy indefinitely, they’ll give you advice on warning signs to look out for and treatment you should seek if you notice problems.

How to Find a Good Cognitive Behavioral Therapist

A lot of the outcome of CBT relies on your relationship with your therapist. Show up to your first session with an open mind and positive attitude. For an effective treatment, both you and your therapist need to be engaged in the process. Finding the right therapist is important, but it doesn’t have to be overwhelming or confusing. Just follow these simple steps to select a CBT therapist.

Look at Their Credentials

The most important thing is to make sure that your therapist has the right credentials. People can offer some forms of therapy without a license. However, only actual licensed counselors have the training needed for CBT. Check to make sure your therapist has their CMHC, MLADC, or other relevant licenses. You can also ask about their background, education, and years of experience to gauge whether or not they’re a reputable counselor.

Make Sure They Treat Your Condition

Not all cognitive behavioral therapists treat the same types of clients. Since CBT has so many uses, you need to make sure the therapist can offer care for your specific situation. Ask about whether they have a background in managing your condition. You might also want to check and see if they offer other treatments for your mental health diagnosis.

See If You Feel Comfortable With Them

While your therapist doesn’t need to be your best friend, it is important to find one who you are comfortable talking with. For example, some patients like a therapist close to their age while others feel more reassured by a counselor who is significantly older than them. It’s a good idea to schedule an initial consultation with a therapist, so you can see whether you feel ready to go on a CBT journey with them.

Ask About Their Prices

When looking at potential CBT providers, don’t be afraid to discuss finances. It’s normal to check on costs and see whether or not the therapist takes your insurance. CBT is offered at a lot of different price points, so if you’re on a budget, you do have affordable options.

After Cognitive Behavioral Therapy: Next Steps in Recovery

Keep in mind that CBT is just one of the many tools in a therapist’s toolbelt. It’s rare for people with mental health challenges to just use CBT and no other treatments. Instead, people typically use CBT alongside a variety of other helpful therapies and medications. For example, a person might take methadone to help with their heroin addiction while also participating in CBT.

Recovering from addiction or other mental health problems is an ongoing journey. No type of therapy, however effective, is an instant cure. Patients need to continue to focus on their well-being after CBT ends. Having support from your community and your addiction recovery team makes a big difference. You might need to continue taking medication or plan on attending group therapy or other treatments.

A good CBT therapist will always be aware that their treatment is just one step in the process. Ideally, your counselor will work with you to find additional treatment options after your CBT ends. In some cases, they might encourage you to take concrete steps, such as joining a halfway house, or they might recommend signing up for ongoing therapy with another provider. Incorporating other treatments in your recovery process ensures that you take the lessons you learn at CBT and apply them to other areas of your life.

Start Your Journey to Mental Health Improvement

Ultimately, CBT can be a very useful way of managing addiction and other mental health issues. If you are interested in trying CBT, Live Free New Hampshire is here to help.

At Live Free New Hampshire, we’re dedicated to helping clients recover from substance use disorders. Our team of professionals has plenty of experience offering CBT and other treatments. We offer a variety of inpatient, outpatient, and sober living rehab programs, so it’s easy to find a treatment that suits your situation.

Ready to start improving your mental and physical health? To learn more about our services, contact the Live Free team today.

Published on: 2023-03-28
Updated on: 2024-05-10