What is Cognitive Behavioral Therapy and How Does it Work?

Cognitive-behavioral therapy, or CBT, is an evidence-based form of treatment for a variety of mental health issues and substance use disorders (SUDs).1,2

If you or a loved one struggles with an SUD (the clinical term for a drug or alcohol addiction) or both addiction and a co-occurring disorder, you can benefit from learning more about CBT and how it might help on the path to recovery.

What is Cognitive Behavioral Therapy?

Cognitive-behavioral therapy is a goal-oriented form of therapy that involves different strategies designed to help you:1,2

  • Manage your emotions.
  • Identify and shift negative or unhelpful thoughts, beliefs, and behaviors.
  • Develop better stress management and problem-solving skills.

CBT works by encouraging you to examine underlying beliefs and thoughts about yourself and the world, how those beliefs and thoughts lead to emotions, and how what you think and feel affects your behaviors, and vice versa.2

What Can Cognitive Behavioral Therapy Treat?

CBT is one of the most widely studied forms of therapy.3 Cognitive-behavioral therapy is effective in treating many conditions, such as:

  • Substance use disorder (SUD), the clinical term for addiction. Research has shown different outcomes for specific SUDs, but CBT has been found to be effective for addiction to alcohol, marijuana, cocaine, methamphetamine, and nicotine, as well as polysubstance abuse.1,3,4
  • Eating disorders. This can include disorders like bulimia or binge-eating disorders.3
  • Anxiety disorders, including generalized anxiety disorder (GAD), social anxiety disorder, panic disorder, and more.5
  • Depression, including major depressive disorder, persistent depressive disorder, seasonal affective disorder, and more.6
  • Bipolar disorder, including both bipolar I and bipolar II.7
  • Schizophrenia.8
  • Posttraumatic stress disorder (PTSD).9
  • Borderline personality disorder.10
  • Obsessive-compulsive disorder (OCD).11

CBT is also effective in treating people with these mental health conditions who also struggle with addiction. This is called having a co-occurring disorder or a dual diagnosis.12

How Does Cognitive Behavioral Therapy Work?

CBT uses different techniques and strategies to help people identify and change maladaptive behaviors.

Cognitive-behavioral therapy works under the assumption that thoughts, emotions, and behaviors are all interrelated. Thus, to change a maladaptive behavior associated with a substance use disorder or any other mental health disorder, the following core principles apply:13

  • Substance use and other behaviors associated with mental health disorders are based, at least in part, on problems with learned behaviors.
  • These maladaptive behaviors are based, at least in part, on problems with thoughts.
  • People who exhibit these behaviors can learn alternate ways of coping, which can help reduce the symptoms of their mental disorder and help them live healthier and more effective lives.

Taking into consideration these understandings, CBT works by helping you:13

  • Recognize distortions in thoughts and looking at them more realistically.
  • Learn to understand the behaviors and motivations of other people more realistically.
  • Develop problem-solving and coping skills.
  • Develop an improved sense of self-confidence in your abilities.
  • Deal with fears instead of avoiding them.
  • Learn different ways of managing stress and calming yourself.

One common strategy is to use role-playing situations to help you prepare to handle specific situations that may arise in your life.13 Through role-playing and other CBT-based exercises, you’ll learn to anticipate problems, develop better self-control, and cultivate healthier and improved ways of coping with problems.14 These interventions can be practiced in both group or individual therapy settings.3

Cognitive Behavioral Therapy for Drug & Alcohol Addiction

Cognitive-behavioral therapy for addiction works by helping people identify and change unhelpful or negative thoughts and behaviors that are related to substance use. You learn different skills and techniques to help prevent or stop substance use and the problems that often go along with it.14

Some of the skills and techniques learned and applied in CBT for addiction treatment include:1,14

  • Examining the pros and cons of ongoing substance use whenever you begin to feel cravings.
  • Recognizing cravings, spotting triggers, and identifying situations that might increase the risk of a relapse and avoiding them when possible.
  • Developing coping skills and behaviors that can help you deal with cravings or other temptations to use. This may involve finding new (or reintroducing) pleasant activities or taking direct action to reduce life stressors (e.g., cleaning your room or filing taxes). It may also involve learning to solve problems effectively through steps such as: analyzing the problem, identifying and considering your options, forming a plan, and executing it.15
  • Analyzing dysfunctional beliefs, thoughts, and behaviors. For example, a therapist may ask you to provide evidence for the accuracy of certain rationalizations you may have regarding substance use, such as “one drink won’t hurt me,” and help you see how these thinking patterns contribute to your addiction.1

CBT can be a beneficial approach as a part of a larger strategy for treating addiction, especially when combined with other types of addiction treatment therapies, frameworks for therapy, and other interventions, which are also provided at Desert Hope. These include:1

What Can I Expect During Cognitive-Behavioral Therapy?

During a typical CBT session, you will work with your therapist in an individual or group format to examine thoughts and learn alternative behaviors and coping skills. The session might start with a check-in about your mood and a brief update, followed by discussing the homework you were assigned, and then diving into the content of the session.17

CBT sessions often involve outlining specific goals in a treatment plan to help you achieve desired outcomes. You’ll be encouraged to journal about your feelings, complete homework assignments, and discuss your feelings and experiences. The therapist may ask you questions like: “Is your perception of things accurate?,” and “what happens if you act differently than you typically would in specific situations?”18

Most people receive individual, weekly counseling sessions that typically take place over a 3–12-month period, which can vary depending on your specific needs.2

Drug Addiction Treatment Near Las Vegas, NV

Desert Hope offers different levels of care, all of which utilize CBT. Each level of treatment involves forming a customized plan based on your needs and is equipped to provide co-occurring disorder treatment if necessary. Types of treatment offered at Desert Hope include:16

  • Medical detox. This can be the first step in recovery. It helps you safely and comfortably withdraw from substances and helps you become medically stable before beginning formal rehab treatment. Medical detox can be managed in an outpatient setting as well as an inpatient setting, where you receive 24/7 medical supervision and care.
  • Inpatient addiction treatment in Las Vegas. An average day in inpatient rehab is spent living onsite and receiving 24/7 care and support. Patients may benefit from the structure and routine provided in residential treatment, especially those with limited family or social support, severe co-occurring disorders, or who lack stable living situations.
  • Outpatient rehab. At our outpatient rehab in Las Vegas, you’ll live at home but travel to our facility on a regular schedule for treatment. We offer highly supportive partial hospitalization and intensive outpatient programs, as well as a standard outpatient rehab program, which offers a less intensive and more flexible option.
  • Aftercare and sober living. Recovery is a lifelong process, so we will work with you to make a plan for the next steps to take when you leave rehab. This could include living in a sober living home as you transition back to your regular life or attending self-help mutual support group meetings like Alcoholics Anonymous.

Patients may go through several stages or step up or down in levels of intensity of rehab. For example, after inpatient rehab ends, patients often continue their treatment in outpatient care.

Hopefully, the prospect of addiction treatment seems less daunting now that you know what to expect from CBT. If you or a loved one struggles with addiction or addiction and a co-occurring mental health disorder, Desert Hope is here to help.

Please contact us or reach out to our confidential helpline at to speak to a caring admissions navigator about CBT and addiction treatment options or to begin the admissions process. Admissions navigators can also explain more about paying for rehab through financing or using insurance to pay for rehab. If you prefer, you can verify your insurance coverage at Desert Hope by completing the confidential .

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