Cognitive Behavioural Therapy in Addiction Treatment

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Cognitive Behavioural Therapy in Addiction Treatment

Cognitive Behavioural Therapy, or CBT, may well be a term you are already familiar with, as it is a well-known and widely-used form of therapy for treating mood disorders, depression, and anxiety.

What you might not know is that it is commonly used as a treatment for a multitude of addictions, including substance misuse disorders and compulsive behaviours, from obsessive-compulsive disorder (OCD) to shopping addictions.

CBT supplies people with the necessary tools to combat destructive behaviours and negative thoughts. It makes recovery possible by targeting the root causes of addictions and helping to replace damaging habits with healthy ones. It looks at where our negative thoughts come from, and how we respond to them, and then works to correct them.

What are the Benefits of CBT?

Negative ways of thinking are often deeply ingrained and can derail you during addiction recovery. Once you get into a pattern of negative thought processes, it can feel inescapable. The main goal of CBT is to empower you to break the cycle of destructive self-talk and put a stop to the resulting behaviours.

CBT is a short-term therapy, meaning that it will typically last up to 20 weeks, during which time you will attend sessions either weekly or fortnightly. It then equips you with knowledge and techniques that you continue to practice day to day.

It means that, rather than signing up for years of therapy and always relying on a therapist to guide you, you are committing to new, positive thought processes and related habits. These can easily become second nature, and the benefits can last a lifetime.

• CBT helps you to analyse your current way of thinking and identify how that ties into your addiction. It is not an instant fix, as it gets right to the core of your problems and helps to discover a solution that is specific to you
• CBT won’t just target the behaviours around your addiction, but will also help in dealing with daily stress, self-esteem, and support general wellbeing
• CBT homes in on pessimistic automatic thoughts – the ones based on impulse, that seem impossible to control, which typically drive substance misuse – and teaches you how to not only dismiss them, but to replace them with positive ones
• CBT looks at your past in order to give you a more positive outlook on the future
• CBT is lead by you. A therapist will be there for support, but the focus is on equipping you with the skills you need to identify the triggers of your addiction and thereby overcome them

How Effective is CBT for Managing Addiction?

CBT isn’t new, it has been thoroughly researched and there is plenty of evidence ^[1] that proves its effectiveness in treating a vast range of mental health problems. Multiple studies ^[2] have been conducted over the years that focus specifically on how cognitive behavioural therapy, often supplemented by complementary treatments, can be helpful for those recovering from addiction.

Addiction and mental health problems are often co-occurring, as problems like depression can lead to people self-medicating with alcohol and drugs. CBT works at tackling both issues at once, as the focus is on reinforcing positive self-talk, offering a brighter perspective, and instilling hope. It makes recovery not only seem attainable but actually become attainable.

As people with substance misuse problems will already be aware, addiction is not cured overnight. It takes time to make or break any habit, and the key is repetition. Cognitive behavioural therapy encourages you to repeat and practice positive self-talk and self-reflection, and thereby form helpful habits that will work against the impulses related to addiction.

What makes CBT especially effective in treating addiction is that it interrupts the negative thought cycles that can often lead to substance use, and fights against the doubting, harmful thoughts that try to undo your recovery progress.

Traditional talking therapy spends a lot of time reflecting on the past, and while CBT also does this, the focus is on how you progress. It will look at any relapses you may have experienced, identify the trigger, and help you to recognise and confront that behaviour in future.

What Addictions is CBT Used to Treat?

CBT has been proven to be an effective treatment for a vast range of struggles, from addictions to mood disorders. It confronts the need for instant gratification, which is often at the centre of addictive behaviours, and introduces new ways of thinking.

Specifically, cognitive behavioural therapy is commonly used to treat:

• Alcohol and drug addiction – a dependency on alcohol or drugs often stems from a perceived need to remove certain feelings. CBT does this by instead analysing those feelings and changing them for the better.
• Gambling addiction – much like substance addiction, gambling addiction is rooted in problems with impulse control and the need for instant gratification, which CBT helps to correct.
• Sexual addiction – this can include addictions to porn, masturbation, and sex, all of which can be combated through talking therapy and examining the surrounding behaviours.
• Eating disorders – compulsive over- and under-eating can have triggers very similar to that of substance misuse, and can be helped by improving a person’s self-esteem and, crucially, self-perception.

Obsessive-compulsive disorder (OCD) – as with the above, CBT looks at the cause of the obsessive impulses that result from OCD and reconfigures the person’s responses to them.

In addition to these, CBT is an extremely effective and clinically-proven therapy for the treatment of:

• Anxiety and depression – by introducing healthier ways of thinking, CBT can diminish the effects of anxiety and depression and make episodes more manageable
• Bipolar disorder – while this is often a result of a chemical imbalance, the highs and lows associated with bipolar disorder can be mitigated by CBT
• Post-traumatic stress disorder (PTSD) – as many CBT sessions are spent reflecting on the past, this therapy can help to reframe trauma and improve how we respond to it

CBT in Rehab

Many rehab centres use cognitive-behavioural therapy as a complement to the traditional 12-step programmes, or typical talking therapies. Rehabilitation centres want to enable patients to be in control of their own recovery after they leave, and CBT is often ideal for this, as it involves many practical exercises that are easy to integrate into everyday life.

The therapists in rehab specialise in addiction, and so they will be able to tailor a CBT programme to your specific needs. You’ll most likely also be around people who are practising the same techniques, so you can support each other.

If you don’t start CBT in rehab, it is available via the NHS, meaning that it is easy to get into and you can self-refer ^[3] if you don’t feel comfortable talking to your GP. Even outside

rehab, there are cognitive behavioural therapists who specialise in helping those with unhealthy addictions, so you know that you’re speaking with someone who really gets it. There are also many helpful online tools, so support is always available if you are struggling between sessions.

References

[1] https://www.efficacy.org.uk/therapy/evidence-cbt-helps-people/

[2] https://beckinstitute.org/treating-substance-misuse-disorders-cbt/

[3] https://www.nhs.uk/service-search/find-a-psychological-therapies-service/