Cognitive behavioural interventions in addictive disorders

We’ve tried, tested, and written unbiased reviews of the best online therapy programs including Talkspace, BetterHelp, and ReGain. By better understanding the difficulties that contribute to https://1stopcg.co.za/2025/07/24/why-you-need-a-sober-support-system/ substance use, people can then look for ways to better manage difficult thoughts, emotions, or situations. Some therapists may offer sliding scale fees, meaning they’ll adjust their fees based on your ability to pay.

• For example, beliefs like «I can’t cope without alcohol» or «I will fail if I try to stay sober» are examined and restructured.
• As with other treatments for alcoholism and drug abuse, including pharmaceutical treatments, cognitive behavioral therapy works best when combined with other recovery efforts.
• Developed in the 1960s by psychiatrist Aaron Beck, CBT emphasizes that psychological issues arise from misinterpretations and maladaptive behaviors.
• More importantly, CBT provides lifelong tools that continue to support mental health and prevent relapse—even years into recovery.
• In many cases, CBT is complemented by medication management to address both substance use disorders (SUDs) and co-occurring mental health issues.
• However, this combination does not consistently produce significantly better outcomes than either treatment alone.

Benefits of CBT for Alcoholism and Addiction

This practice encourages patients to observe their emotional responses without judgment, allowing for more effective coping. Identifying triggers is a central focus in Cognitive Behavioral Therapy (CBT) for addiction recovery. Triggers can be environmental stimuli, emotional states, or specific situations that provoke cravings for substances. Through techniques like functional analysis, individuals learn to recognize how their thoughts and feelings link to their substance use behavior. Cognitive Behavioral Therapy has solidified its standing as a cornerstone in addiction treatment, underpinned by robust evidence and a comprehensive understanding of its methodologies. By fostering self-awareness, cognitive restructuring, and effective coping mechanisms, CBT empowers individuals to reclaim control over their lives from the grip of addiction.

The Importance of Learning to Ask for Help

Identifying triggers and high-risk situations is the next crucial step in relapse prevention. CBT can help you learn the skill of identifying distorted patterns of thinking that cause uncomfortable feelings. Many people find it difficult to change their thought patterns, and even more difficult to spot them in the first place. Through CBT, individuals learn practical skills for handling stress, managing emotions, and navigating social pressures—without turning to substances.

The importance of addressing social isolation in recovery

CBT also involves learning and practicing new skills to cope with cravings, triggers, and difficult emotions that will arise during recovery. You might learn mindfulness techniques, relaxation strategies, and assertiveness training to help you manage cravings and navigate challenging situations. In 2015, the criteria for empirically supported treatments were revised and updated to account for the increased volume of treatment outcome research as well as improved methodological rigor and evaluation tools (see Tolin, McKay, et al., 2015 for discussion of specific updates made). The criteria require more stringent evidence for the efficacy of treatments, as well as explicit consideration of key contextual factors such as efficacy Twelve-step program among people from diverse backgrounds and cost. The Society for Clinical Psychology subsequently adopted these revised criteria, referred to as the “Tolin Criteria,” and established procedures for updating empirically supported treatment designations under the Tolin Criteria. To date, the Tolin Criteria have been applied to Exposure and Response Prevention for Obsessive-Compulsive Disorder (Tolin, Melnyk, et al., 2015), Cognitive Behavioral Therapy for Insomnia (Boness et al., 2020), and Contingency Management for Substance Use Disorders (Pfund et al., 2021).

• Specifically, VV and FS independently extracted all effect sizes related to substance use quantity and frequency and psychosocial outcomes (if available) for each comparator group and each follow-up time frame reported.
• We also combine CBT with other effective treatments to give you the best chance at lasting recovery.
• With many of these conditions (including depression, OCD, and anxiety disorders), CBT has consistently been found to be the most effective psychotherapy method and is suggested as the frontline treatment.
• Subsequently inadequate coping and lack of assertiveness and low self-efficacy maintained his drinking.

In addition to the quality of the evidence rating, the GRADE system also allows consideration of additional contextual factors in the overall treatment recommendation. In the case of CBT for SUD, the quality of the evidence is strengthened by several additional contextual factors (see Table 4). Technology-delivered CBT has also demonstrated efficacy for substances beyond alcohol, including cocaine use disorder and cannabis use disorder (Carroll et al., 2008, 2014). The effect sizes observed for technology-delivered CBT on substance use outcomes are similar to effect sizes for all technology-delivered substance use treatments, including CBT and non-CBT interventions (e.g., Motivational Interviewing) (Rooke et al., 2010; Tait et al., 2013). Platforms for delivering addiction interventions via technology are diverse and multiplying rapidly. In the sections below we will cover only those which (1) are explicitly or predominantly cognitive-behavioral in focus (although several include components of MI and other interventions), (2) the primary targeted outcome is alcohol or drug use, and (3) the intervention is delivered online.

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This systematic review and treatment evaluation found that cognitive behavioral therapy’s effects on substance use are larger in magnitude when inactive (minimal) versus active treatment is the comparison group and that these effects tend to diminish with time. Cognitive behavioral therapy is cognitive behavioral therapy for addiction therefore considered an evidence-based treatment for substance use disorder according to current evidence-based treatment guidelines. Lastly, additional clarity is needed regarding the conditions under which CBT for SUD might be most effective. There were somewhat mixed findings regarding the efficacy of CBT by specific SUD type. One meta-analysis concluded that relapse prevention was more efficacious for alcohol and polysubstance use than smoking or cocaine use (Irvin et al., 1999).

Therapists encourage active participation from clients, fostering an environment where individuals feel empowered to share their thoughts and experiences. This active involvement not only enhances the therapeutic process but also promotes accountability in one’s recovery journey. Techniques like journaling and self-monitoring tasks between sessions help solidify this engagement by allowing clients to reflect on their progress and challenges. The cognitive approach is fundamental in understanding addiction, particularly through identifying cognitive mechanisms that influence substance use. These mechanisms consist of automatic and controlled processes that interact in complex ways. At Arista, we offer compassionate, evidence-based, and trauma-informed care to help you heal, grow, and move forward.