Therapy is an important tool for overcoming addiction. Having someone to talk to and brainstorm solutions with to interpersonal, environmental, or emotional problems can bring the support and clarity needed to resist urges and remain sober.

According to the National Institute on Drug Abuse, one of the most effective forms of therapy used to treat alcohol abuse disorders and cocaine addiction is Cognitive Behavioral Therapy, commonly referred to by its acronym CBT.

How Cognitive Behavioral Therapy Works

CBT is based on the idea that a person can learn how to rewrite faulty thinking patterns when faced with stressful situations, conditions or circumstances. Working with a licensed CBT therapist, the patient learns techniques and skills for managing stress and regaining control over their responses – rather than reactions – to situations. The idea is that the patient may not be able to control everything that happens in their life, but they can set goals and choose how to respond to obstacles in a way that leaves them feeling dignified and with self-respect. They also are left not further exacerbating harmful reactions to unwanted situations.

For example – in sobriety, someone with an alcohol addiction may be offered a drink repeatedly at a work event. Rather than sink into anger and give in, CBT teaches the person to acknowledge their anger, check the costs and benefits of letting it decide your actions, choose how to effectively reject the drink offer and turn towards talking to other people, or engaging in an activity, that will distract and remove the temptation.

The therapy works in a very structured format, seeking to identify the patient’s concerns and address them so that a higher quality of living is possible after treatment. Unlike traditional talk-therapy, CBT seeks to find solutions, change cognitions and responses, and give the patient more control through 4 main processes. The Mayo Clinic, a foundation for medical education and research, outlines the typical steps in CBT treatment:

• “Identify troubling situations or conditions in your life.” The first step in CBT therapy is to address distressing issues, such as mental illness, addiction, family or relationship issues or trauma. Awareness of what could be at the root of escape to drugs or alcohol is the foundation for developing new management techniques.
• “Become aware of your thoughts, emotions and beliefs about these problems.” Not only the issues in our lives, but the way we feel and think about them can shape our behavior. Faulty cognitions can lead us to misunderstand how or how strongly things have control over us. An article published in Treatment Intervention Protocol explains it clearly: “Cognitive theory assumes that most psychological problems derive from faulty thinking processes…The way we act and feel is most often affected by our beliefs, attitudes, perceptions, cognitive schema, and attributions. These cognitive factors serve as a template through which events are filtered and appraised. To the extent that our thinking processes are faulty and biased, our emotional and behavioral responses to what goes on in our life will be problematic. According to this theory, changing the way a client thinks can change the way he feels and behaves.”
• “Identify negative or inaccurate thinking.” The therapist will likely ask specific details about how you respond or react to stressful issues. Physical reactions, such as sweating or fast heart-beat; thinking, such as racing thoughts or catastrophic thinking; and behaviors, such as turning to alcohol to alleviate the uncomfortable feelings or avoiding situations that cause you stress are all examples of ways the individual may have become conditioned to respond, cope and maladapt to issues that actually contribute to making the problem worse.
• “Reshape negative or inaccurate thinking.” The hardest work comes in here. The therapist will likely encourage you to challenge your existing thoughts and responses. Are they appropriate for the situation? Do they improve the situation, or make it worse? Is it based on facts, or inaccurate perceptions? Does it reinforce negative or promote positive feelings about yourself? With time, challenging your existing ideas and behaviors becomes easier and more like second-nature.

CBT is a lot of work, but it is an effective form of therapy to treat some addictions. By enlisting a therapist to challenge you to reroute ineffective thinking and take action that will lead to less harmful outcomes, CBT allows your to regain control of your behaviors, thoughts and life.