Cognitive-Behavioral Therapy (CBT) targets the behavior and thought patterns (cognition) that the patient has. It is used in many treatments, including substance use disorders (SUDs). By using this method, the patient begins to understand how their negative thoughts and attitudes directly affect their behavior.
What is Cognitive Behavioral Therapy?
Cognitive Behavioral Therapy (CBT) is a common form of “talk therapy” that probes the conflicts in your behavior between what you want to do and what you actually do. An example of this is addiction. You don’t want to be addicted, yet you behave in ways that keep you dependent. And although people with addictions regret that behavior, it can be difficult to stop repeating it. Sometimes the person doesn’t even know why.
CBT is based on the principles of behaviorism, which is concerned with how people’s behaviors can be controlled or changed and theories of cognition, which focus on understanding how people think, feel, and understand the world. It is an effective goal-oriented and short-term treatment that takes a matter-of-fact approach to solve problems.
Goal of CBT
The goal is to readjust the patterns of thinking or behavior that led to the patient’s difficulties. The therapist does this by exploring the patient’s thoughts, images, beliefs, attitudes, and relationships. Once you have identified the relationship between your problems, behavior, and thoughts, you can begin to learn ways to cope and manage your thoughts and emotions during and after treatment.
How Does CBT Help With Addiction?
As mentioned, addiction is an example of a behavior pattern that goes against what the person in that situation wants to do. People trying to overcome addictive behaviors often say they want to change that behavior or any other behaviors that are causing problems, but it is very difficult to do so.
Using the cognitive behavioral therapy approach, addictive behaviors are the result of inaccurate thoughts and consequential negative feelings. This includes behaviors such as alcohol and drug abuse, gambling problems, food addiction, and other forms of excessive harmful behavior,
CBT explains this occurrence by illustrating the way that people’s thoughts and emotions interact. Psychologists understand that many of us have thoughts that are based on beliefs that are untrue unrealistic or impossible to accomplish. These thoughts then cause negative feelings that feed anxiety, depression, and conditions like substance use disorder.
CBT starts by recording thoughts, correlating feelings, along with the events that trigger them, and the behaviors that result. We can change the automatic processes that hinder efforts to change behaviors. By examining patterns of thoughts and feelings that we frequently experience, we can begin to change those thoughts.
We change those thoughts by looking at situations in more realistic ways that don’t automatically lead to negative emotions and harmful behaviors. By rewarding ourselves for healthier behaviors, over time, healthier behaviors become associated with positive emotions and become automatic.
Your therapist will teach you how to make changes you can put into practice immediately. These are skills you can use for the rest of your life. Depending on your goals, there are several ways to approach CBT. Whatever method your therapist takes, it will include:
- Identifying specific issues or problems in your everyday life.
- Becoming aware of nonproductive thought patterns and how they affect your life.
- Identifying negative thinking and reframing it in a way that changes how you feel.
- Learning and practicing new behaviors.
9 Strategies of Cognitive Behavioral Therapy
After talking to you and learning more about your issues, your therapist will decide which CBT strategies would be the best for you. Techniques most often used in CBT include these 9 strategies:
Cognitive Restructuring or Reframing
This strategy makes it necessary to take an honest look at negative thought patterns. You may tend to think in general terms and assume the worst will happen or place too much importance on minor details. This kind of thinking can affect what you do and even become a self-fulfilling prophecy.
Your therapist will ask you about your thought process in different situations so you can identify negative patterns. After you become aware of them, you can learn to reframe those thoughts, so they are more positive and productive.
An example might be: “I can’t quit using drugs because I’m just a loser at everything” can become “Addiction is a disorder, and I can learn ways to get better, just like I have learned other things.”
During a guided discovery, the therapist will familiarize themselves with your viewpoint. They’ll ask questions meant to challenge your beliefs and expand your thinking. You might be asked to give evidence that supports your belief and evidence that doesn’t. Through this process, you will learn to see things from different sides, particularly ones you may not have even considered before. This helps guide you to choose a more helpful path.
Exposure therapy can be used to challenge fears and phobias. Your therapist will slowly expose you to the things that prompt fear or anxiety while guiding you on how to cope with them at the moment. This may be done in small steps. Eventually, exposure therapy can make you feel less anxious and more confident in your ability to cope.
Journaling and Thought Records
Writing is a common way to get in touch with your own thoughts. Your therapist might ask you to list negative and positive thoughts that come to you between sessions. Another writing assignment would be to keep track of new thoughts and new behaviors you’ve put into practice since the last session. Putting it in writing can help you understand how far you’ve come.
Activity Scheduling and Behavior Activation
There might be an activity you tend to put off or avoid due to fear or anxiety. Putting it on your calendar can help. Once the pressure of decision-making is gone, you are more likely to follow through. Activity scheduling like this can help establish good habits and provide substantial opportunities to practice what you learned.
Behavioral experiments are usually used for anxiety disorders that involve “catastrophic thinking.” Catastrophic thinking is when you always assume that the worst thing will happen in any situation and exaggerate the problems you face. Before beginning a task that usually causes you to be anxious, you will be asked to predict what will happen.
Later on, you will talk with your therapist about whether your prediction was correct. Over time, you’ll realize that the predicted catastrophe is really not very likely to occur. You’ll start with low-anxiety tasks and build from there.
Relaxation and Stress Reduction Techniques
In cognitive-behavioral therapy, you will learn practical skills to help you lower stress and increase your sense of control. This is helpful when dealing with phobias, social anxieties, and other stressors. You will learn some progressive relaxation techniques such as:
- Deep breathing exercises
- Muscle relaxation
Role-playing helps you work through different behaviors in difficult situations. Playing out possible storylines can lessen fear and is used for:
- Improving problem-solving skills
- Becoming familiar and confident in certain situations
- Practicing social skills
- Assertiveness training
- Developing communication skills
This concerns taking tasks that appear to be overwhelming and breaking them into smaller, more achievable parts. Each successive part builds upon the previous so you gain confidence as you go, piece by piece.
CBT for Relapse Prevention
One encompassing benefit of cognitive therapy in the treatment of substance use disorders is the emphasis on long-term maintenance. People with SUDs are often susceptible to relapse. Therapists teach patients a new set of attitudes and skills they can rely on for the long-term. This not only improves the patient’s sense of self-sufficiency but can lead to a reduction in life stressors that might increase the risk of a relapse.
Cognitive Behavioral Therapy was developed as a way to prevent relapse when treating alcohol use disorder (AUD). It was later adapted for people with cocaine addiction. One of the elements of CBT is anticipating problems and improving patients’ self-control by helping them establish effective coping strategies.
Specific techniques include looking at the positive and negative consequences of drug use, self-monitoring to recognize cravings early, and identifying situations that might trigger use. Patients learn to develop strategies for dealing with cravings and avoiding high-risk situations.
Research shows that skills learned through cognitive behavioral therapy remain after completing treatment. Current research is looking at how to produce even more powerful effects by combining CBT with medications for drug abuse and with other types of behavioral therapies. A computer-based CBT system has been developed and is effective in helping reduce drug use after standard drug abuse treatment.
Does Cognitive Behavioral Therapy Have Any Risks?
CBT is not considered a risky therapy, but there are some things to bear in mind:
- Some people might find it stressful or uncomfortable to confront their problems.
- Some types, such as exposure therapy, can increase stress and anxiety while you work through it.
- CBT doesn’t work overnight. You must be willing and committed to working on techniques between sessions and after therapy ends. It is a change of lifestyle that you follow and improve upon through your life.
Do You Want to Change Your Life?
If you or a loved one are struggling with a substance use disorder or other addiction, you can change your life, or help them change theirs at Unity Behavioral Health. We have a professional, caring staff you can depend on to help you through this difficult time. You can learn to control your behaviors and come out on the other side with a new chance at a full and satisfying life.
At Unity, we offer evidence-based approaches such as cognitive-behavioral therapy and many others because you need a program designed specifically for you. Our facilities are located in Palm Beach and Martin Counties, Florida, with amenities and activity therapies based on your needs.
You should contact us now. We are always available to you.