Cognitive Behavioral Therapy for Substance Abuse Recovery
Individuals who come to treatment are often conflicted. Substance abuse has negatively impacted their lives, but they cannot imagine a better or different future without it. The goal of cognitive behavioral therapy (CBT) is to help individuals change their lives by placing more emphasis on things they need to value, rather than what their addiction is telling them to value.
CBT helps them envision how their lives would improve if they pursued aspirations aligned with their values. When individuals reflect on their values and aspirations, they can see their actions’ short-term and long-term effects. As a result, individuals are motivated to change old habits and adopt healthier lifestyles.
The management of emotions is a vital therapy goal. Long-term use of substances can make a person numb to life’s events, and people who stop using substances may find it uncomfortable to discover they can feel a plethora of emotions again.
To learn to control their feelings more effectively, individuals can establish a sleep schedule, adopt a healthier diet, and modify the physical aspects of their emotions. Activities such as relaxation techniques and mindfulness exercises can effectively help people tolerate and manage emotions they haven’t felt for a long time. There is no limit to the number of people who can benefit from these techniques, regardless of their background or history related to substance abuse.
What is CBT?
Cognitive behavioral therapy is a popular form of psychotherapy, or “talk therapy.”
A trained therapist helps the client explore feelings and behaviors in a safe, confidential setting to learn effective coping strategies. The technique is widely used in addiction treatment, rehab, and recovery to identify substance abuse triggers and develop methods for controlling them. By learning to connect thoughts, feelings, and actions, CBT helps people recovering from a substance use disorder become more aware of how these things affect their health.
Cognitive behavioral therapy is:
- Powerful and Constructive: According to the American Psychological Association, CBT can teach clients how to modify destructive thoughts and behaviors that lead to substance abuse. The clients develop a more positive attitude toward life, leading to more productive and healthy experiences.
- Organized: Each CBT session has a plan, and clients learn what techniques they will use each session. The CBT process enables individuals to establish and achieve tangible life-after-addiction goals.
- Collaborative: During CBT, both the therapist and client must be actively involved. Therapists can help clients determine how to make positive changes in their lives once they reveal what they wish to change.
- Flexible: CBT focuses on flexibility, and even clients enrolled in outpatient programs who don’t attend sessions frequently can benefit from it.
A wide variety of mental and behavioral health disorders can be treated with CBT, including:
- Substance Use Disorders (SUD)
- Alcohol Use Disorders (AUD)
- Depression
- Anxiety disorders
- Panic disorder
- Obsessive-compulsive disorder (OCD)
- Post-traumatic stress disorder (PTSD)
- Eating Disorders: Examples include anorexia nervosa, bulimia, and binge eating disorder.
Negative behaviors or mental health disorders often plague a person struggling with an addiction. CBT is based on understanding the relationship between feelings, thoughts, and behaviors. All these factors influence daily decisions, actions, and overall well-being; therefore, a person’s recovery can be positively impacted by increasing awareness of these factors.
How Does CBT Help in Recovery?
In order to overcome drug addiction and alcoholism, CBT consists of the following steps:
- Dismissing false beliefs and insecurities that cause substance abuse
- Providing tools for self-improvement
- Developing effective communication skills
As a result of addiction, individuals often develop negative beliefs about themselves and their abilities. Known as instinctive negative thinking patterns, they result from misconceptions and internalized feelings that can lead to doubt and fear.
Often, people will self-medicate by abusing alcohol and drugs in an attempt to regulate their automatic thoughts. At times, these thoughts are associated with painful memories and past traumas, but these connections can be unlearned by revisiting them regularly and processing them during therapy.
A client also learns to anticipate potential problems, such as triggers, and how to cope with them if they arise. CBT involves exploring the consequences of regular drug use and practicing identifying and avoiding situations that might trigger a relapse.
Examples of CBT techniques and how they help:
Combating Negative Thoughts
In treatment, clients can examine their automatic negative thoughts and objective evidence supporting or refuting them. Through critical evaluation, the goal is to think more rationally and less harshly.
- This: “My home life is too much. I need to drink to feel better.”
- Eventually becomes: “It’s normal to have fights with family members, and I can learn from this. My family will appreciate me learning from my mistakes and listening to them. No amount of alcohol can make me feel better about a situation.”
- This: “I’m a bad person anyway, so I might as well mess up my life by using.”
- Eventually becomes: “I’m doing the best I can with what I know right now. I deserve a clear mind to overcome these obstacles.”
Imagery Based Exposure
The purpose of this exercise is for those in recovery to focus on a memory that generates powerful negative emotions, paying attention to every sight, sound, feeling, thought, and impulse at that moment. Frequently revisiting painful memories over time can reduce anxiety caused by them. By carefully using exposure therapy techniques, people can learn how to approach and overcome their fears. To achieve this, they must face and master each fear one by one until they are no longer afraid.
- Example: A young man recalls a painful childhood memory. He recalls every detail and emotion at the moment. After repeated exposure, the memory causes less and less pain, reducing the need for self-medication because the memory is no longer suppressed; it allows for acceptance, adjustment, and growth.
Pleasant Activity Schedule
It is often the case that addicts cannot experience pleasure when they are not using drugs. CBT therapists will work with individuals to select activities relevant to their interests and include them in a master schedule. The individual will spend less time seeking and using drugs by having scheduled activities.
People who engage in these exercises increase their competence and pleasure, gathering evidence that contradicts their beliefs about themselves and substances. Mastery and enjoyment serve as positive reinforcement for engaging in different activities. Through repetition of these newfound hobbies, coupled with positive experiences, new beliefs can be formed about their capabilities and capacity for happiness.
The idea is to break up daily routines by planning healthy, occupying activities each week. The tasks should be easy to perform and encourage positive emotions. Having these leisure activities scheduled helps reduce negative automatic thoughts and the subsequent need to use drugs or alcohol.
- Example: Instead of taking drugs or drinking on the job, a highly stressed Marketing Specialist relaxes at his desk for 15 minutes daily. This time is spent discovering and enjoying new music.
- Example: Instead of using drugs or drinking to cope with college and its harsh reality on time management, a student opts to go to bed an hour or two earlier than usual to feel well-rested and prepared for the next day, rather than relying on drugs to stimulate energy for them.
A short list of some of the attitudes and skills learned in cognitive therapy includes:
- Engaging in constructive activities, talking to supportive people, attending meetings, and other positive means to delay and distract cravings until they subside.
- Learning and practicing appropriate assertive comments for politely declining offers of drinks (or other substances) (e.g., “Thanks, but I’m in the mood for a ginger ale with lots of ice.”
- Support from healthy social networks, such as 12-step fellowship (12SF) meetings, friends and family who support sobriety, and keeping away from those threatening therapeutic progress.
- Lifestyle changes promote sobriety and self-efficacy, such as healthy daily routines, meaningful hobbies, and spiritual practices.
A cognitive behavioral therapy approach demonstrates that many harmful emotions and actions cannot be rationalized or explained. As humans, we are constantly confronted with thoughts, feelings, and behaviors without taking the time to reflect upon them. It may be the result of past experiences or environmental factors that cause these feelings and behaviors. Those struggling with addiction are better equipped to overcome their addiction when they understand why they feel or act the way they do – and how those feelings and actions lead to substance abuse.
Get Help Today
In CBT, negative thought patterns and behaviors are restructured into healthier ones. It’s changing how you feel or act toward something by changing your thoughts about the situation. With CBT, you can reframe your situation to avoid triggers when dealing with addiction.
Although cognitive behavioral therapy is effective for many individuals with addiction issues, there are additional options that you may want to consider. A combination of psychotherapy and medication is common, such as antidepressants. Depending on your needs, clinicians may “mix and match” skills from various psychotherapies.
At Discovery Point Retreat, we’re here to guide clients through treatment from beginning to end. We believe each individual deserves a personalized approach, with their needs being put first. CBT has dramatically benefitted those in recovery from substance abuse and those with various mental health issues. However, it works best when tailored to the individual and part of a comprehensive treatment program.
If you feel that you need help with an addiction and want to learn more about medical detox, residential, and outpatient drug rehab in Dallas, Texas, don’t hesitate to call us at 855-306-8054 or contact us online.
SOURCES:
- https://nida.nih.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral-therapies/cognitive-behavioral-therapy
- https://www.psychiatrictimes.com/view/cognitive-behavior-therapy-and-medication-assisted-treatment-for-opioid-use-disorder
- https://beckinstitute.org/blog/treating-substance-misuse-disorders-with-cbt/