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Cognitive Behavioral Therapy For Addiction

An Evidence-Based Psychological Technique For Treating a Range of Addictions

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Updated June 24, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

A picture of a CBT therapy session.

A CBT therapy session.

Image © David Buffington / Getty Images

Cognitive Behavioral Therapy, also known as Cognitive Behavior Therapy or CBT for short, is a type of “talk” therapy, based on the psychological principles of behaviorism and theories of cognition. CBT is a variation of behavior therapy, which focuses on changing behavior through positive and negative reinforcement, or rewards and punishment.

The human experience of cognition includes our perceptions, thoughts, emotions and understanding. Adding analysis of cognition to behavior therapy led to the development of cognitive behavioral therapy. CBT particularly explores the conflicts between what we want to do and what we actually do. Addiction is a clear example of this –- while addicts will often say they want to change their addictive behavior, and may genuinely want to quit alcohol, drugs, or other compulsive behaviors that are causing them problems, they find it extremely difficult to do so.

Cognitive behavioral therapy explains this by clarifying the way that people’s thoughts and emotions interact. Psychologists realized that many of us hold beliefs that are untrue, unrealistic, or impossible to live up to, and these thoughts, in turn, cause negative feelings which feed anxiety, depression and conditions like addiction. By systematically recording our thoughts and associated feelings, along with the events that trigger those thoughts and feelings, and the behavior that we carry out as a result, we can begin to change the automatic processes that sabotage our efforts at changing our behaviors.

According to the cognitive behavioral therapy approach, addictive behaviors, such as drinking, drug use, problem gambling, compulsive shopping, video game addiction, food addiction, and other types of harmful excessive behavior, are the result of inaccurate thoughts and subsequent negative feelings. CBT has an excellent track record, with numerous studies demonstrating its effectiveness in treating depression, anxiety and other conditions, including addiction.

The CBT approaches that became popularized towards the end of the 20th century are themselves being refined and replaced by so-called “third wave” of behavior therapy, which focus on mindfulness, acceptance and being in the moment. These approaches include Acceptance and Commitment Therapy (ACT), Dialectical Behavioral Therapy (DBT), Mindfulness-Based Cognitive Therapy, and Functional Analytic Psychotherapy.

Sources

Burns, D. Feeling Good: The New Mood Therapy. (Revised Edition). HarperCollins: New York. 1980.

Burns, D. The Feeling Good Handbook. (Revised Edition). Penguin: Harmondsworth. 1999.

Ledley, D., Marx, B. and Heimberg, R. Making Cognitive Behavioral Therapy Work. New York: Guilford Press. 2005.

Linehan, M. Cognitive-Behavioral Treatment of Borderline Personality Disorder. New York: Guilford Press. 1993.

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