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Cognitive Behavioral Therapy (CBT) in Addiction Treatment

Substance use disorder (SUD) treatment often involves different types of behavioral therapy, and one of the most common is cognitive-behavioral therapy (CBT). 1, 2 CBT is an evidence-based therapy that helps people understand the relationship between their emotions, thoughts, and behaviors, including substance use.2  

Finding a treatment center that offers CBT may be helpful for your, or a loved one’s, recovery. This page will help you learn more about CBT, including how it works as a part of a comprehensive addiction treatment plan, and how to find a facility that offers CBT near you.

What Is Cognitive Behavioral Therapy?

Cognitive-behavioral therapy is a type of therapy based on the cognitive, or thought-based, model of mental illness.2 It is a collaborative, solution-oriented form of therapy designed to help people understand maladaptive emotions, thoughts, and behaviors and provides tools to help them change these patterns.2 In this way, CBT enables people to be their own therapists and equips them with skills to help themselves.2, 3

The cognitive model involves the idea that a person’s emotions and behaviors are influenced by their thoughts and perceptions of events.2 The cognitive model is based on three concepts, including a person’s core beliefs, dysfunctional assumptions, and negative automatic thoughts.2 These things can influence a person’s behavior, how they relate to themselves, others, and the world around them, and how they see the future.2

How Does Cognitive Behavioral Therapy Work?

Cognitive behavioral therapy for addiction treatment works by helping people identify and modify unhelpful emotions and thoughts that contribute to maladaptive behaviors, including substance use.1 CBT guides people through the process of recognizing, avoiding, and coping with situations and triggers that can lead to substance use.1 CBT is a collaborative process involving the cooperative efforts of the person and therapist.3

CBT uses different techniques to help people build skills to promote abstinence and recovery and can also help address problems related to substance use.1, 4 For example, a person may have the belief that they cannot deal with stress without drinking. A therapist may challenge this belief and work with the person to help them create alternative ways of dealing with stress that do not involve substance use.5

A typical CBT session may involve different components, such as:5

  • Analyzing the person’s substance use.
  • Examining the person’s thoughts and behaviors about substance use.
  • Helping the person identify and set realistic goals.
  • Checking in with the person to assess challenges they encountered throughout the week.
  • Working on specific skills relevant to the person.

CBT interventions may include training to help with communication, problem-solving, refusal skills, social skills, and stress management.5

Cognitive behavioral therapy in drug and alcohol rehab often involves 12-16 sessions, usually over 12 weeks.5 It can take place in different settings, including inpatient addiction treatment, which involves living onsite at a rehab for the duration of treatment. Here patients receive 24/7 care and participate in different therapies, which often include CBT.6 Another setting includes outpatient addiction treatment programs, which can take place on different levels of intensity depending on a person’s needs.6 Patients live at home and travel to rehab on a set schedule to participate in treatment.6

Goals of Cognitive Behavioral Therapy

The goals of cognitive behavioral therapy include:1, 3, 4, 5

  • Identifying and modifying maladaptive thought patterns related to substance use.
  • Self-monitoring and developing strategies to manage situations to use substances.
  • Reducing substance use.
  • Building skills necessary to prevent relapse.
  • Increasing confidence and feelings of self-efficacy in a person’s ability to avoid substance use.

Does Cognitive Behavioral Therapy Help in Addiction Treatment?

Yes, cognitive behavioral therapy can help in addiction treatment and there is significant evidence attesting to its effectiveness.5 CBT for substance use disorder (SUD) has been shown to be effective in different meta-analytic reviews, with large effect sizes ranging from low to moderate when compared with other interventions, and large effect sizes when compared to no treatment at all.7

Studies have shown that CBT can help reduce substance use, especially for cannabis, cocaine, opioids, and polysubstance use, help prevent relapse, and help people dealing with co-occurring disorders, such as anxiety or depression.7, 8, 9 One study of psychosocial interventions for people with cocaine dependence found that 60% of patients in the CBT group provided clean toxicology screens at the 52-week follow-up.7

Combining CBT with other therapies, particularly motivational interviewing (MI), may strengthen the likelihood of behavioral change, and MI can enhance a person’s motivation to engage in CBT treatment as well as remain in and adhere to treatment.10

Clinical reviews have found consistent evidence that the combination of CBT and motivational enhancement therapy (MET), which uses MI techniques, is one of the most helpful ways to reduce cannabis use. Other studies have found that combined CBT and MI produced beneficial treatment outcomes for co-occurring alcohol use disorder (AUD) and major depressive disorder when compared with treatment as usual.10

Benefits of Cognitive Behavioral Therapy for Drug and Alcohol Addiction Recovery

Does cognitive behavioral therapy help in rehab? Yes, CBT can provide numerous benefits for addiction recovery, such as:3, 5, 8

  • Reducing substance use.
  • Helping people cope with negative emotional states, such as anger, boredom, grief, or guilt, without the use of substances.
  • Helping people cope with negative physical states, including fatigue, pain, or withdrawal, without the use of substances.
  • Decreasing the likelihood of relapse.
  • Improving assertiveness and communication skills.
  • Improving a person’s confidence.
  • Learning better ways to understand the motivations and behaviors of others.
  • Improving a person’s ability to relax and self-soothe.

Does Insurance Cover Cognitive Behavioral Therapy in Rehab?

Insurance coverage can vary but often covers cognitive behavioral therapy, at least in part.11 CBT is a type of addiction therapy, and the Affordable Care Act (ACA) states that substance use disorder (SUD) treatment is an essential benefit.12 All Marketplace plans that cover SUD treatment must provide comparable coverage to what they offer for medical and surgical procedures.11  Specific benefits can vary, so check with your insurance provider to verify your health insurance coverage for rehab.

Many factors can influence the cost of treatment, including your insurance coverage, copays, the type of treatment you receive, and the specific setting (e.g., inpatient or outpatient treatment).11 If you don’t have insurance, you may be able to find free or low-cost treatment, inquire about grants or scholarships, attend a rehab that offers a sliding scale based on income, or ask about payment plans.13

Find Cognitive Behavioral Therapy Addiction Treatment Near You

The first step in finding cognitive behavioral therapy near you might be to discuss your situation with your doctor so you can have an evaluation and ask for referrals to rehabs that offer CBT. You can also call specific treatment facilities and inquire about their programs.

Need assistance? You can call American Addiction Centers at to learn more about rehabs that offer cognitive behavioral therapy, or to ask questions about the treatment process. Our helpline is available 24/7 and is confidential and free, with no obligation to enter treatment. If you’re not ready to talk on the phone, you can easily browse our rehab directory to find treatment locations near you.

Other Addiction Therapy Methods

In addition to cognitive behavioral therapy, several evidence-based therapies have been proven effective in the treatment of substance use disorder (SUD). Therapies that are often used to treat SUD include:

Some rehabs may also offer holistic and alternative therapies, such as:

  • Meditation for addiction treatment. This can help people cultivate mindful acceptance of their circumstances, accept distressing emotions, and cope with stress and cravings.15
  • Yoga for addiction treatment. This promotes mindfulness and may help people cope with stress, cravings, and emotional reactivity.15
  • Art and music therapy for addiction treatment. This can help people express emotions that might be difficult to verbalize, promote positive change, and help people relax.16
  • Equine-facilitated psychotherapy. This can help people overcome resistance to treatment, increase prosocial behaviors, and reduce symptoms of depression.17
  • Acupuncture for addiction treatment. This is a traditional Chinese medicine intervention that may alleviate certain symptoms of SUD, such as anxiety.18

Find freedom from addiction today. Your health insurance provider may be able to cover all or part of the cost of rehab. Use the form below to find out instantly.

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