Cognitive Behavioral Therapy in Addiction Treatment

Cognitive behavioral therapy (CBT) is one of the most common therapies used to treat mental and behavioral health issues like drug and alcohol addiction.

People who want to recover from drug and alcohol abuse can take part in CBT sessions through their addiction treatment program. And CBT has many benefits for people in addiction recovery, including helping them learn healthier behaviors and thought patterns.

Read on to learn more about how CBT works to treat addiction, which programs use CBT, and where you can find CBT sessions for drug and alcohol treatment in North Carolina.

About Cognitive Behavioral Therapy for Addiction

Cognitive behavioral therapy is a form of psychotherapy, also called talk therapy. It’s one of the most commonly used behavioral health therapies in mental health treatment.

CBT helps people in substance abuse treatment by teaching them to focus on the present, not the past. 

The principles of CBT are centered around a person’s thoughts, feelings, and behaviors and how they affect your life.

CBT works by helping you look at these elements, so you can identify problem areas. Then, you work with your mental health professional to come up with healthier strategies to deal with those issues.

In this way, CBT arms people in recovery with the coping skills they need to confront situations that lead them to turn to alcohol or drug use.

Key Facts on CBT

  • CBT is one of the most commonly used and highly effective therapies in mental health care.
  • CBT is different from other mental health treatments, because it focuses on the problem and working through it in real time to find a solution.
  • CBT is most effective when you work closely with the right therapist. 
  • This form of therapy can address many mental health issues, like anxiety, depression, substance abuse, gambling issues, eating disorders, and more.

How Does CBT Work in Addiction Treatment?

CBT works in addiction treatment programs by making people in recovery aware of their substance use behaviors. 

This includes how they respond to triggers, or people, things, or situations that lead them to use drugs and alcohol.

In practice, this looks like teaching a person with a substance use disorder (SUD) how to:

  • Refuse drugs or alcohol in the moment
  • Problem solve on their own
  • Recognize situations that lead to drug or alcohol use before they happen
  • Change daily behaviors in a way that lends to recovery, not alcohol/drug abuse

Otter House Wellness offers evidence-based outpatient programs with CBT for people in recovery.

What Types of Programs Offer CBT?

Since CBT is so common, it’s part of a range of levels of care at addiction treatment centers. Here are the different rehab programs that may include CBT.

One on One Therapy Sessions

Individual therapy sessions with CBT may take place weekly for up to 12 to 16 weeks, depending on the level of care you choose.

You’ll work closely with a cognitive behavioral therapist to:

  • Find the negative thought patterns you want to change
  • Decide what should change
  • Learn coping skills and coping strategies to achieve your goals
  • Set expectations for your sessions

In this way, CBT is a collaborative effort between you and your therapist to help you change maladaptive thoughts and behaviors.

Sessions focus on helping you reach the goals you set for yourself.

Group Therapy

Sometimes, CBT is offered in support group formats. This is also called cognitive behavioral group therapy or CBGT.

In CBT group sessions, you can get help and support from your peers who are also in recovery. Seeing others learning how to change their thoughts and behaviors offers a sense of encouragement.

You may also learn from others by witnessing their work within the group.

Residential Programs

Most often, CBT is offered as part of a comprehensive treatment plan for addiction, such as in residential or inpatient programs.

Residential rehab allows patients to stay onsite at a treatment center for the length of their program, usually two weeks to 30 days or more. Here, they receive daily support, medical monitoring if needed, detox, and therapy.

In these programs, CBT is just one part of a holistic treatment approach, which aims to treat the whole person.

Outpatient Rehab Programs

Outpatient programs offer a similar level of treatment intensity, without requiring the patient to stay overnight.

Outpatient treatment comes in many levels of care, including partial hospitalization, intensive outpatient treatment, and general outpatient programs. 

All levels of outpatient programs may offer CBT, depending on the treatment facility. Otter House Wellness in North Carolina provides outpatient CBT sessions in all levels of care.

Types of Cognitive Behavioral Therapy Techniques

There are a range of CBT techniques your therapist may use to help you address your substance misuse or other mental health condition.

The most common CBT treatment strategies are:

  • Cognitive restructuring: Also called reframing, this technique has you walk through your thinking patterns step by step. This way, you can see what your negative thought patterns look like, become more aware of them, and find ways to reframe them.
  • Exposure therapy: This form of CBT helps you confront your fears. It’s ideal for those with phobias. With your therapist’s help, you can slowly be exposed to things which bring you fear until you are able to deal with them on your own.
  • Behavioral experiments: Helpful for people with anxiety disorders, these experiments ask you to take a hard look at a task that makes you anxious. Before you start, the therapist will want you to predict the (anxious) outcome. Later, you’ll look at the outcome and see if it came true. This technique teaches your mind to confront anxiety.
  • Relaxation techniques: Such as breath work, mindfulness, and guided imagery. Relaxation therapy helps you gain a sense of control and manage disorders such as social anxiety and stress.
  • Successive approximation: For people who have a fear of a certain task, this technique allows them to work toward a goal (like breaking addictive behaviors) by taking it step by step. Along the way, you’ll be rewarded for completing each step.
  • Activity scheduling/behavior activation: In this type of CBT, you set an activity plan to give yourself something to look forward to. This is especially helpful for people in recovery, as they need mood-enhancing activities to replace substance use.

How Effective is CBT in Drug and Alcohol Treatment?

CBT has shown to be a highly effective treatment for substance use disorder. Keep in mind that it’s most effective when used as part of a larger, intensive treatment plan.

That is, CBT is not a standalone treatment for drug and alcohol abuse. It must be used together with other evidence-based interventions aimed at treating all aspects of a person’s mental, physical, and behavioral health.

People in CBT as part of behavioral treatment see better and longer-lasting outcomes than people who had no treatment or minimal treatment, according to one study reported by the National Institute of Mental Health.


If CBT helps people find ways to deal with stressors in their lives, DBT (dialectical behavior therapy) helps them look at the actual stressors and learn ways to balance emotions to manage stress.

CBT focuses on actions you can take, a form of skills training that’s important in helping you achieve and maintain recovery.

In contrast, DBT (another form of cognitive therapy) helps people learn ways to accept themselves, love themselves, and find a sense of safety by managing their own emotions.

Both CBT and DBT may play important roles in recovery from alcohol or drug addiction. Which treatment (or both) may be right for you depends on your recovery goals.

Benefits of Cognitive Behavioral Therapy in Addiction Recovery

CBT is one of the top treatment options for both mental illness and alcohol and drug abuse. As part of a comprehensive treatment program, CBT can teach you important coping methods that will serve you for years to come.

Here are some of the most important benefits you may enjoy from CBT sessions:

  • Learning to see and get rid of false beliefs/insecurities that prompt you to use drugs or alcohol
  • Finding self-help methods to enhance your mood
  • Learning real-time methods for relapse prevention in recovery, like identifying high-risk situations and how to avoid them
  • Improving your communication skills, so you can advocate for yourself
  • Helping you find ways to reframe your thoughts to manage triggers and cravings
  • Changing your core beliefs about yourself and your self-worth, which may lend to alcohol or drug use
  • Helping you recognize distortions in thinking you may have that are specific to substance use, such as “I’ll just have one drink” or “This one time won’t hurt or create a pattern”

Cost of CBT Programs

The cost of CBT in programs for drug and alcohol use disorders ranges from about $150 per weekly session to several thousand dollars for the entire program.

Keep in mind that health insurance can decrease your out-of-pocket costs, depending on your plan’s coverage and if you have any copays or need to meet deductibles.

Otter House Wellness offers payment plans and various options to patients and works with a range of health insurance plans.

Find Personalized CBT Sessions at Otter House Wellness

Whether you’re looking for short-term or long-term outpatient treatment with CBT in North Carolina, Otter House Wellness can help.

Here, you can find effective, research-backed treatment for addiction for yourself or a loved one, without putting your life on hold.

Find out how we can help. Call Otter House Wellness today to learn more about our comprehensive outpatient rehab programs.

Frequently Asked Questions

What mental health disorders does CBT treat?

CBT can treat a range of mental health and substance use disorders, including addiction, anxiety, depression, bipolar, eating disorders, and problem gambling.

Can you recover from addiction for good with CBT?

Addiction is a chronic illness. While you can learn ways to enter recovery long-term (sort of like remission with other illnesses), you may never be ‘cured.’ Instead, you can use methods like CBT to give you ways to manage elements that lend to substance abuse, like drug use triggers and cravings.

Is CBT a good treatment for everyone with addiction?

Not everyone will be a good candidate for CBT. People addicted to opioids, for example, may need to undergo detox before starting therapy. Others may benefit more from other therapy methods. Discuss your recovery needs and goals with a healthcare provider to learn which treatment approaches are right for you.


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