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Reviewed by Cognitive Behavioral Therapy (CBT) is one of the most widely used psychotherapeutic approaches and is considered highly effective for treating a range of mental health issues, including substance abuse disorders.
CBT was originally designed to address depression; however, it has evolved into a versatile treatment modality that is frequently used to manage anxiety, post-traumatic stress disorder (PTSD), addiction, and more.
The key to CBT is that it focuses on identifying and restructuring dysfunctional thought patterns and behaviors to support healthier ways of thinking, feeling, and acting. In this article, you will learn about the basics of CBT, how it works, how it can be applied to treat substance abuse disorders, exercises that can be done during therapy sessions, and costs.
Table Of Contents:
- What is Cognitive Behavioral Therapy
- Cognitive Behavioral Therapy Techniques
- Reasons to Get Cognitive Behavioral Therapy
- Cognitive Behavioral Therapy in Substance Abuse Treatment
- Cognitive Behavioral Therapy Exercises
- Rehab Facilities that Offer Cognitive Behavioral Therapy
- Cognitive Behavioral Therapy Costs
- Cognitive Behavioral Therapy to Overcome Addiction
What is Cognitive Behavioral Therapy
CBT is a type of therapy that works based on the idea that our thoughts, feelings, and behaviors are interrelated and that by following this, you can work on changing negative thought patterns.
This therapeutic approach involves structured, goal-oriented sessions where patients learn to recognize and address their unhelpful thinking styles. This kind of therapy is focused on the present and centers on concrete problem-solving strategies.
Cognitive Behavioral Therapy Techniques
CBT generally follows a structured approach where patients and therapists collaboratively set goals and work on identifying specific problems.
During sessions, therapists help patients learn skills to change maladaptive thoughts and behaviors, leading to improvements in emotional regulation. Over time, these skills become internalized, enabling patients to manage their symptoms even after therapy concludes.
One of the most appealing aspects of CBT is its emphasis on measurable goals and practical exercises, which encourage patients to apply what they’ve learned in therapy to real-life situations.
Reasons to Get Cognitive Behavioral Therapy
Cognitive Behavioral Therapy is a structured, evidence-based approach that consistently demonstrates effectiveness across a wide range of mental health conditions.
Studies have shown that CBT can be effective for people dealing with depression and anxiety disorders, and when talking about substance use disorders, research indicates that CBT can reduce relapse rates by 50% or more compared to classical approaches.
Its focus on practical skills, such as cognitive restructuring and mindfulness, empowers individuals to manage symptoms outside of therapy by addressing the root of negative thought patterns driving harmful behaviors.
CBT helps patients reframe distorted thoughts and develop healthier coping mechanisms, reducing the urge to self-medicate.
By actively engaging patients in goal-setting and skills practice, CBT encourages empowerment and self-efficacy, which are critical for sustaining recovery and managing triggers and stressors effectively.
Cognitive Behavioral Therapy in Substance Abuse Treatment
Cognitive Behavioral Therapy is particularly useful in treating substance abuse because it addresses underlying cognitive and behavioral patterns that contribute to addiction.
Many individuals with substance use disorders struggle with negative thought patterns, such as feelings of hopelessness, low self-worth, and anxiety, which can drive the desire to use substances as a form of escape. By targeting these maladaptive thoughts, CBT helps patients develop healthier coping mechanisms and find alternative ways to manage stress and triggers without turning to substances.
In substance abuse treatment, CBT often involves helping patients identify triggers that lead to substance use and how to face them. Through cognitive restructuring, patients learn to reframe these triggers in healthier ways. Therapists work with patients to develop coping skills and relapse prevention strategies that empower them to manage cravings and avoid high-risk situations.
| Stage | Description | How to Use It in Substance Abuse Treatment |
| 1. Assessment | The therapist gets information about the patient’s history, symptoms, and goals to create a tailored plan. | Understanding the triggers, history, and individual treatment needs. |
| 2. Psychoeducation | Patients learn the basics of CBT and how thoughts, emotions, and behaviors are interconnected. | Teaching patients about addiction cycles, triggers, and how these affect their thinking, but also how their thinking impacts these behaviors. |
| 3. Goal-Setting | Specific, achievable goals are established collaboratively with the patient. | Setting goals like avoiding certain high-risk situations. |
| 4. Intervention | The therapist implements CBT techniques like cognitive restructuring, exposure, and behavioral activation. | Working on exercises to reframe negative thoughts that lead to substance use. |
| 5. Relapse Prevention | Patients learn strategies to maintain progress and avoid old behaviors. | Developing coping strategies and emergency plans for dealing with high-risk situations. |
Cognitive Behavioral Therapy Exercises
Cognitive Behavioral Therapy exercises are practical tools designed to help patients recognize and alter their thought patterns and behaviors.
One common exercise is thought records, where patients document negative or automatic thoughts during stressful situations, rate their intensity, analyze them, and work to reframe them in a more balanced way.
Another effective technique is behavioral activation, which encourages individuals to engage in positive activities to improve their mood and reduce avoidance behaviors, which is particularly helpful for those dealing with depression and addiction.
Mindfulness and relaxation techniques are also employed to help patients stay grounded in the present moment, which can be particularly beneficial for managing cravings and reducing stress.
These exercises are tailored to individual needs and are practiced during therapy sessions as well as in daily life.
| Type of Exercise | How It Works |
| Thought Records | Involves documenting and reframing negative thoughts during stressful situations. |
| Behavioral Activation | Encourages engaging in positive activities to boost mood and reduce avoidance. |
| Mindfulness and Relaxation Techniques | Helps patients stay focused on the present moment to manage stress and cravings. |
Rehab Facilities that Offer Cognitive Behavioral Therapy
Cognitive Behavioral Therapy is a widely utilized treatment approach in rehabilitation centers across the United States.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), approximately 93.8% of all treatment facilities offer CBT as part of their services. This equates to about 15,075 facilities nationwide.
Cognitive Behavioral Therapy Costs
The cost of Cognitive Behavioral Therapy can vary widely depending on several factors such as location, the provider’s credentials, whether the therapy is in-person or online, and whether it is covered by insurance.
On average, a single session of CBT can range from $100 to $200 or more in the U.S., though prices may be lower or higher based on where you live and the therapist’s expertise.
Many insurance plans cover at least part of the cost of therapy sessions, which can make it more affordable.
For individuals without insurance coverage, some community clinics, nonprofit organizations, or online platforms may offer CBT at a reduced cost or on a sliding fee scale based on income. Additionally, some therapists may offer flexible payment plans to accommodate financial constraints.
Overall, while CBT can be relatively costly, its emphasis on short-term, goal-oriented treatment often means fewer sessions are needed compared to other therapeutic approaches, potentially making it more cost-effective in the long run.
Insurance Companies that Cover Cognitive Behavioral Therapy
Cognitive Behavioral Therapy (CBT) is often covered by insurance, as mental health parity laws require that mental health services are covered comparably to physical health services.
Rules of coverage vary depending on the insurance provider, your plan, and whether the selected therapist is in-network or not.
Major insurance companies, including Blue Cross Blue Shield, Aetna, Cigna, UnitedHealthcare, and Kaiser Permanente, typically cover CBT sessions, but individual plans may have limitations, such as a maximum number of sessions or specific copayment requirements. Medicaid and Medicare also cover CBT for substance abuse.
Here’s a table summarizing coverage by major insurance companies:
| Insurance Provider | Specific Limitations |
| Blue Cross Blue Shield (BCBS) | Limitations may include a maximum number of covered sessions per year, varying copayments, and the requirement to use in-network therapists for full benefits. |
| Aetna | Coverage may require pre-authorization for therapy sessions and could limit the number of covered visits per year, depending on the plan. |
| Cigna | Plans may have specific copayments and session limits or require the use of in-network providers for coverage. |
| UnitedHealthcare | Coverage may include restrictions such as limited session counts, higher copayments for out-of-network providers, and possible pre-authorization requirements. |
| Kaiser Permanente | Generally requires patients to see in-network providers within the Kaiser system and may have limited availability for mental health services based on demand. |
To determine your exact coverage, review your policy documents, contact your insurance provider, and verify if your chosen therapist is within the insurance network.
Cognitive Behavioral Therapy to Overcome Addiction
CBT’s structured, skill-based approach is particularly well-suited for addressing the complexities of substance abuse.
As patients progress in therapy, they gain greater control over their thoughts, which translates to more control over their actions. Research has shown that individuals who undergo CBT for substance use disorders often experience lower relapse rates and better long-term outcomes.
By addressing both the cognitive and behavioral facets of addiction, CBT allows individuals to break free from the patterns that perpetuate substance abuse. Over time, they become more resilient to stressors, more confident in their ability to manage cravings, and better equipped to build a fulfilling life without substances.
In conclusion, Cognitive Behavioral Therapy is a highly effective, evidence-based approach for treating substance abuse.
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Page Sources
- National Library of Medicine: Comparing the Effectiveness of Cognitive-Behavioral Therapy and Brief Intervention on Relapse Prevention among Drug Users
- Jama Network: Combined Pharmacotherapy and Cognitive Behavioral Therapy for Adults With Alcohol or Substance Use Disorders
- National Survey of Substance Abuse Treatment Services. (2021, July 14). https://www.samhsa.gov/data/data-we-collect/n-ssats-national-survey-substance-abuse-treatment-services
- Springer Nature Link: Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy
- NCDAS: Average Cost of Drug Rehab