Cognitive Behavioral Therapy (CBT) for Addiction

Cognitive Behavioural Therapy (CBT) is an evidence-based modality of counselling that is highly effective in treating various mental health disorders, including drug and alcohol addiction. This therapeutic approach combines cognitive therapy, which focuses on identifying and changing negative thought patterns, and behavioural therapy, which emphasizes changing maladaptive behaviours. By addressing both the cognitive and behavioural aspects of addiction, CBT Therapy offers you a holistic and structured approach to treating addiction.

What is Cognitive Behavioural Therapy (CBT)

Before delving into the application of CBT Therapy in addiction treatment, it is important to understand the foundational principles of this therapeutic approach. CBT Therapy is based on the notion that our thoughts, emotions, and behaviours are interconnected. It operates on the premise that by identifying and challenging negative thoughts and beliefs, you can adopt healthier coping strategies and ultimately change your behaviour patterns.

When it comes to addiction, CBT Therapy offers a unique perspective. It recognizes that addiction is not solely a result of physical dependence on a substance, but also a complex web of psychological factors. By addressing the underlying cognitive and behavioural aspects of your behaviour, CBT aims to provide you with the tools and skills necessary to overcome your substance abuse issues.

The Connection Between Addiction and Mental Health

It is crucial to recognise the intricate relationship between addiction and mental health. Substance abuse and mental health disorders frequently occur together, creating a complex dual-diagnosis situation. Understanding the connection between addiction and mental health is vital in finding treatment that addresses both aspects simultaneously.

When exploring the connection between addiction and mental health, it is evident that they operate in a continuous cycle. This cycle is marked by the underlying feelings and thoughts triggered by mental health disorders such as anxiety or depression. Followed by a compulsion to use substances which provide temporary relief or pleasure, but ultimately lead to negative consequences. This consequence of the addictive behaviour then further compounds the mental health issues and the cycle continues round and round. This pattern reinforces the difficulty of breaking free from the cycle.

However, there is hope. Cognitive Behavioral Therapy (CBT) aims to interrupt this cycle by targeting the underlying thoughts and beliefs that perpetuate the addictive behaviours. By addressing these cognitive factors, you can gain a deeper understanding of your addiction and develop healthier coping mechanisms.

Below we will discuss the core elements of CBT therapy and how they aid in combatting addiction.

8 Core Elements of CBT therapy that help to combat addiction


Cognitive Restructuring

This involves identifying and challenging negative or distorted thought patterns (cognitive distortions) that contribute to our addictive behaviour. Through cognitive reframing, you learn to replace unhelpful thoughts with more realistic and balanced ones. For example when your mind justifies why drink is a good idea you can pause and reframe the thinking to be more realistic and remind yourself of the consequences if you drink too much again. 


Behavioural Activation

This involves identifying and modifying behaviours that contribute to our addiction. It often includes activity scheduling, where you plan and engage in rewarding and pleasurable activities that become your healthy coping mechanism. This allows you to soothe feelings of stress, depression or anxiety rather than numbing them with drugs or alcohol.


Exposure Therapy

This is a key component in overcoming the social side of addiction. When learning to be around drink or drugs without partaking it is important to build up. For example, starting out with going out for dinner with your partner and not drinking, then seeing some close friends and getting through it sober then eventually being able to be at a wedding or birthday and have the condense and trust that you're going to stay sober. By exposing yourself to these situations in a controlled and systematic way it helps you build your confidence and overcome your fear.


Skills Training

CBT often involves teaching practical psychological skills such as mindfulness, mediation, problem-solving and communication. These skills really help you navigate and manage your thinking around drugs and alcohol along the journey of recovery.


Homework Assignments

Between therapy sessions, you may be assigned homework exercises to practice the skills you've learned and to continue challenging maladaptive thoughts and behaviours in your daily lives.



Keeping track of thoughts, emotions, and behaviours can help you identify patterns and triggers of your addiction. Self-monitoring is often done through the use of journals or worksheets.


Relaxation Techniques

Learning relaxation techniques such as deep breathing, progressive muscle relaxation, or mindfulness meditation can help individuals manage stress and reduce cravings.


Collaborative and Empathetic Therapeutic Relationship

A strong therapeutic alliance between the therapist and the client is essential in CBT. The therapist provides empathy, support, and guidance while the client applies the tools taught. The joint effort of both the therapist and the client ensures the best outcome for the client.

That is why it is crucial to apply these tools to address these underlying mental health concerns through CBT Therapy. By targeting the root causes of addiction and co-occurring mental health disorders, you can enhance your overall well-being and improve your chances of sustaining recovery.

Through CBT Therapy, you can learn effective strategies to manage your mental health symptoms, develop healthy coping mechanisms, and build resilience. By addressing both addiction and mental health fully, you can experience long-lasting recovery and improved quality of life.

CBT For Alcoholism

CBT for alcohol use disorder or alcohol addiction typically involves identifying and challenging cognitive distortions and beliefs related to alcohol use disorder. By recognizing and questioning these thoughts, you gain a more accurate and balanced perspective on your alcoholism, which can lead to behavioural changes. Additionally, CBT focuses on developing effective coping strategies to manage cravings, urges, and triggers, empowering you to make healthier choices about your alcohol abuse.

Challenges and Limitations of CBT for Addiction

While CBT Therapy has demonstrated efficacy in treating addiction, it is essential to acknowledge the potential challenges and limitations associated with this approach.

One challenge is the limited availability of CBT within healthcare systems such as the NHS (National Health Service). Due to resource constraints, CBT may be offered only for a limited number of sessions, which could restrict the depth and duration of treatment.

Another challenge lies in the specialized knowledge required to effectively address addiction issues. While CBT therapists are trained in cognitive restructuring and behaviour modification techniques, they may have limited expertise in understanding the complexities of addiction. This can pose difficulties in addressing the underlying psychological factors contributing to addictive behaviours.

Moreover, finding a therapist with expertise in both CBT and addiction can be challenging. Many individuals seeking therapy may encounter professionals who are proficient in CBT but lack sufficient understanding or personal experience with addiction. It is crucial to find a counsellor who possesses personal experience with addiction or has received specialized training in addiction treatment.

At Lisa Inside Addiction, all our counsellors have extensive experience in both CBT and addiction. Our team understands the unique challenges faced by individuals struggling with addiction and is equipped to provide tailored support and guidance.
Additionally, for individuals with severe addiction or dependence on drugs and alcohol, CBT alone may not suffice. In such cases, a medical detoxification process may be necessary to safely manage withdrawal symptoms and stabilize the individual before initiating CBT therapy.

From Theory to Practice: Our Lead Addiction Counsellor Luke Worsfolds Perspective on Cognitive Behavioural Therapy (CBT)

“As an addiction counsellor, I find Cognitive Behavioural Therapy (CBT) to be a highly valuable and effective approach to the treatment of drug and alcohol addiction. The strength of CBT Therapy lies in its structured, evidence-based framework that not only addresses the immediate issues related to substance use but also delves into the underlying cognitive and emotional patterns contributing to the addiction.

From my perspective, the aspect of CBT Therapy that stands out is its holistic approach. By focusing on the interconnection between thoughts, feelings, and behaviours, CBT Therapy provides a comprehensive treatment strategy. This is particularly important in addiction, where the cycle of negative thinking, emotional distress, and maladaptive behaviours is often deeply entrenched. By breaking down this cycle, CBT Therapy empowers individuals to understand and modify their thought patterns, leading to more positive outcomes and behaviours.”

- Luke Worsfold - Lead Addiction Counsellor


Frequently Asked Questions

How does CBT compare to other treatment methods for addiction?

Cognitive Behavioural Therapy (CBT) focuses on identifying and changing negative thought patterns and behaviours related to addiction. It is more structured and goal-oriented than some other therapies, such as psychodynamic therapy, which explores past experiences and subconscious thoughts. Compared to medication-assisted treatments, CBT addresses the psychological aspects of addiction without pharmaceutical intervention, though it can be combined with medications for a more comprehensive approach. Group therapy provides peer support and shared experiences, while CBT is often conducted in one-on-one sessions, though it can also be adapted for group settings.

What is the cognitive approach to drug addiction?

The cognitive approach to drug addiction focuses on understanding how negative thoughts and beliefs contribute to addiction behaviours. It aims to identify and challenge these harmful thought patterns and replace them with healthier, more rational ones. By addressing the mental aspect of addiction, the cognitive approach helps individuals develop coping strategies to deal with cravings, avoid triggers, and ultimately change their relationship with drugs or alcohol.

How long does CBT typically take to show results?

The timeframe for seeing results from CBT can vary based on the individual's circumstances, the severity of the addiction, and their level of engagement with the therapy. Typically, CBT for addiction can range from 5 to 20 sessions, with many individuals beginning to see positive changes within 5 to 10 sessions. However, it's important to note that progress can continue to evolve and solidify over time beyond the initial sessions.

Can I practice CBT on my own?

While CBT is typically guided by a trained therapist, there are aspects of CBT that can be practised on one's own, especially with the aid of books, online resources, or mobile applications designed to teach CBT techniques. Self-guided CBT can help individuals learn to identify negative thought patterns and develop better coping strategies. However, for those dealing with severe addiction or co-occurring mental health disorders, working with a professional is highly recommended to ensure the most effective and safe treatment.


Last edited on: 07-05-24

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Clinically reviewed on: 07-05-24

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