Cognitive Behavioral Therapy

Cognitive-Behavioral Therapy (CBT) is a psycho therapeutic approach that emphasizes the connections between how we think, feel, and behave. The cognitive part of CBT involves examining the automatic, irrational, and maladaptive thoughts related to a particular person or problem. In the case of substance use, CBT would examine thought patterns during, before, and after the use of any substance. A person may have recurring automatic thoughts that cause them to seek out substances. The clinician using cognitive-behavioral therapy would help the person identify these thoughts and realize the connection they have to the resulting behaviors. The person is then taught other coping behaviors to use instead of substance use. The person also is taught that the automatic thoughts and beliefs are not necessarily true and are akin to hypotheses that need to be tested. The behavior part of CBT involves examining what behaviors occur before, during, and after the use of any substance that result from the underlying irrational beliefs. This examination is sometimes called a functional analysis and can help a person identify and cope with triggers. CBT strategies include skills training using role plays, behavioral modeling, practice exercises, realistic goal setting, and reward contingencies (i.e., reinforcement). Another technique involves documenting automatic thoughts to become more aware of patterns of thinking. In this sense, CBT views substance use as a learned behavior that can be unlearned through the development and use of new skills, more adaptive thinking processes, and a change in reinforcement patterns.