Reviewed by Bill Wilson, MS, Chief Program Officer at Gaudenzia
Cognitive Behavioral Therapy (CBT) is one of the best studied and most effective forms of psychotherapy commonly practiced today. As the name suggests, CBT combines cognitive therapy — a type of psychotherapy that deals with negative thoughts about oneself and the world — with behavioral therapy, which focuses on identifying and changing destructive behavioral patterns.
CBT can be tailored to address specific concerns, such as in substance use disorder treatment (sometimes referred to as addiction treatment). The underlying principle of CBT posits that our thoughts, feelings, and behaviors are all interconnected and impact our general well-being.
Looking for “CBT near me”? If you or someone you love needs help with substance use and co-occurring disorders, please call our 24-hour Treatment and Referral HelpLine at 833.976.HELP (4357) or email helpline@gaudenzia.org
What Does Cognitive Behavioral Therapy Involve?
CBT helps individuals identify harmful thought patterns and behaviors while reinforcing helpful ones. Through a combination of evidence-based therapy methods and behavioral practice, CBT teaches clients to understand how their thoughts, feelings, and behaviors interconnect and influence each other.
Here is a closer look at how cognitive therapy and behavioral therapy work, respectively.
Cognitive Therapy
Cognitive therapy helps an individual identify and change distressing or false beliefs, allowing them to form a clearer picture of their own thoughts and expectations. Common negative or unhelpful thought patterns include:
- Overgeneralizing — According to the American Psychological Association, overgeneralizing is a “cognitive distortion in which an individual views a single event as an invariable rule, so that, for example, failure at accomplishing one task will predict an endless pattern of defeat in all tasks.”
- Catastrophizing — This occurs when an individual assumes the worst outcome will happen and often involves exaggerating difficulties or believing a situation is worse than it is.
- Minimizing — Minimizing is a cognitive distortion that occurs when we reduce the significance of an event, such as downplaying our own accomplishments, or believing that a negative or traumatic event is less significant than it really is.
- Mind Reading — The habit of “mind reading” is a thinking pattern where we expect others to know what we are thinking without having to tell them, or believing we know what others are thinking without them having to tell us.
- Absolutist Thinking — This occurs when an individual thinks in terms of totality, often expressing thoughts about events as occurring “always” or “never,” rather than being situational.
When it comes to treating substance use disorders, these are just a few examples of many different cognitive distortions clients often engage in as part of their cognitive schema. When clients fail to recognize and address these destructive thought patterns, they lead to equally harmful feelings and behaviors. Cognitive restructuring interventions help clients free themselves from these dangerous belief patterns.
Behavioral Therapy
Behavioral therapy originates from “behaviorism,” a theory that assumes our behaviors are learned, and can therefore be “unlearned” or modified. This mode of therapy seeks to identify destructive behavioral patterns that may cause or intensify problems. Once problematic behaviors are identified, individuals work to replace them with healthier alternatives.
Behavioral therapy includes learning new coping mechanisms for demanding situations, such as stressful events or periods of depression and/or anxiety. As it relates to substance use and co-occurring disorders, a destructive behavioral pattern might involve an individual with an anxiety disorder who uses substances like drugs or alcohol to feel less anxious.
During behavioral therapy, the individual learns to recognize this destructive behavioral pattern and works to replace it with healthier coping mechanisms, like engaging in self-care, reaching out to a support network, or taking proper medications as prescribed and when appropriate.
What Are Examples of Cognitive Behavioral Therapy?
CBT helps individuals identify and change destructive thought patterns and the resulting behaviors that complicate their lives or put strain on their relationships. By replacing negative thoughts with more realistic, accurate beliefs, individuals can think more clearly and exert greater levels of control over their own thoughts, feelings, and behaviors.
Destructive thought patterns can result in “self-fulfilling prophecies,” in which our negative beliefs about a situation cause us to behave in ways that bring those negative expectations to fruition.
As an example, if we erroneously believe that a person dislikes us, we may behave coldly toward them, which in turn could cause that person to truthfully dislike us. This, of course, only confirms and strengthens our initial negative belief, which can make us feel badly about ourselves. In time, we may begin to over-generalize this thought pattern into a belief that most people do not like us and apply the same counter-productive behaviors to future interactions with others, damaging our social relationships.
CBT encourages challenging negative beliefs and replacing them with positive or neutral beliefs, like considering whether a person is simply having a difficult day, rather than assuming they dislike us. As a result, we may behave kindlier toward the person in question. This is more likely to result in a positive or neutral response, rather than creating a negative outcome.
Cognitive Behavioral Therapy at Gaudenzia
Gaudenzia provides CBT treatment across Pennsylvania, Maryland, Delaware, and Washington, DC. Our treatment model uses an evidence-based, person-centered approach to treatment for substance use and co-occurring mental health treatment. We help individuals and families break the cycle by developing strong coping skills and social supports while maintaining medication adherence when prescribed.
At Gaudenzia, we blend Albert Ellis’ Rational Emotive Behavioral Therapy with Aaron Beck’s Cognitive Therapy model in both individual and group therapy interventions. Gaudenzia helps clients recognize, challenge, and restructure risky thought patterns into more helpful, self-promoting thought patterns. This is followed up by a series of skills transfer, where adaptive coping and social skills are applied as a re-learned behavioral repertoire.
Gaudenzia provides trauma-informed, gender-responsive, and culturally responsive care.
If you or someone you love needs help with substance use and co-occurring disorders, please call our 24-hour Treatment and Referral HelpLine at 833.976.HELP (4357).
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Common Questions About CBT
Which substance use disorders respond best to CBT treatment?
Research shows that CBT is particularly effective for several types of substance use disorders, with cannabis use disorder showing the strongest positive outcomes in clinical studies. CBT has also demonstrated significant success in treating cocaine use disorder, opioid use disorder, and alcohol use disorder through its approach of modifying substance-related thought patterns and developing healthy coping behaviors.
Which co-occurring mental health disorders respond best to CBT treatment?
CBT demonstrates exceptional effectiveness in treating mood disorders (including major depression and bipolar disorder), anxiety disorders, and post-traumatic stress disorder (PTSD) when they co-occur with substance use. The therapy’s structured approach helps reduce both psychiatric symptoms and substance use simultaneously, while improving treatment adherence and preventing relapse.
How long does CBT treatment typically last?
CBT is typically a short-term treatment that lasts between 12 to 16 weeks, with sessions occurring once or twice per week. However, the duration can vary based on individual needs, severity of symptoms, and whether you’re addressing substance use alone or co-occurring mental health disorders. Some clients may benefit from shorter periods, while others might need extended support for sustainable recovery.
What should I expect in my first CBT session?
Your first CBT therapy session focuses primarily on assessment and goal-setting. A licensed therapist will work with you to understand your specific challenges, substance use history, and treatment objectives. Together, you’ll develop a personalized treatment plan that addresses both immediate concerns and long-term recovery goals. This initial session also introduces the basic concepts of CBT and how they’ll apply to your recovery journey.
Is CBT covered by insurance?
Most insurance plans cover CBT as part of substance use disorder treatment, especially when provided by licensed professionals in accredited facilities like Gaudenzia. Coverage details vary by insurance provider and plan type.