Cognitive Behavioral Therapy for Alcoholism

What Is Cognitive Behavioral Therapy (CBT)?

Cognitive Behavioral Therapy (CBT), developed by psychiatrist Aaron Beck, is a type of behavior therapy that explores how patients’ thinking interacts with how they feel and what they do. It has been proven to be an effective treatment for alcoholism (alcohol use disorder) and other substance use disorders (SUD), both as a lone therapy and in combination with other treatments. 


Cognitive behavioral therapy (CBT) is also known as a short-term therapy technique because it typically requires only twelve sessions or less to notice results. 

How does CBT work?

Cognitive behavioral therapy (CBT) differs from other forms of psychotherapy because it helps change peoples’ attitudes and behaviors by focusing on their thought patterns, or cognitive processes, and how they influence their behaviors. This type of therapy seeks to identify negative or unwanted behaviors and thoughts and shift them towards healthier behaviors and thoughts.

CBT treatment can help patients with alcoholism understand the thoughts that drive their abusive drinking and learn coping mechanisms to prevent it. 

What Are the Three Goals of Cognitive Behavioral Therapy?

  1. Change negative thinking patterns 

CBT curbs negative thoughts by revealing the motivations behind harmful behaviors.

  1. Change unhelpful behavior patterns 

CBT discourages negative behaviors and reinforces positive behaviors.

  1. Teach coping strategies 

CBT encourages healthy coping mechanisms as an alternative to harmful behaviors.

What does CBT Do to The Brain?

Behavioral treatments for alcoholism such as Cognitive Behavioral Therapy affect brain function in ways that help patients stay the course in recovery. CBT focuses on enhancing coping skills as well as understanding the factors and triggers that result in continued drug or alcohol use.

Studies show that individuals who undergo CBT experience brain activity changes, which suggests that CBT may improve brain functioning.

How Effective is CBT for Substance Abuse?

Research also shows that CBT effectively treats substance use disorders (SUD), including alcoholism, when paired with additional treatments, such as a standard outpatient program. In addition, CBT also demonstrates greater long-term durability than other therapies when used for addiction treatment. 

CBT treats substance use disorders (SUD) by mitigating the reinforcing effects of substances on behavior. CBT does this by building positive associations with abstinence and teaching coping skills.

CBT has been an effective treatment for many other mental health conditions, such as: 

  • Anxiety disorders (including social anxiety)
  • Attention deficit disorder (ADD)
  • Bipolar disorder
  • Obsessive-compulsive disorder (OCD)
  • Eating disorders
  • Post-traumatic stress disorder (PTSD)
  • Other physical illnesses like chronic pain

One study found that CBT is more effective in treating alcohol use disorder (AUD) than no treatment. CBT is also more effective for alcoholism relapse prevention when used in combination with medication. 

Another study found that patients who received CBT, in addition to other alcoholism treatments, had fewer drinking days.

Types of Cognitive Behavioral Therapy Techniques

Here are some techniques commonly utilized by CBT therapists during Cognitive Behavioral Therapy (CBT):

Cognitive Restructuring 

This type of talk therapy allows patients to notice and change negative thinking patterns, or cognitive distortions. When used to treat patients overcoming alcoholism (alcohol use disorder), cognitive restructuring allows the patient to be aware of thinking patterns that reinforce unwanted behaviors, such as alcohol use. It can also help patients to re-wire negative beliefs about abstinence.

Behavioral Assignments 

Also called homework assignments, behavioral assignments may be used in CBT to allow the patient to apply what they’ve learned in therapy and build new positive behaviors and habits. For patients overcoming alcoholism, these homework assignments can help them remember what they learned in therapy. They can also apply the techniques outside of the treatment environment when facing external triggers. Research shows that the completion of behavioral or homework assignments improves the outcome of treatment.

Exposure Therapy 

Exposure therapy involves exposing the patient to their cues for substance abuse in a safe, controlled therapy environment. Exposure therapy can help patients reduce unwanted behaviors by exposing a patient to these triggers and allowing them to process the resulting emotions and sensations.

Activity Scheduling 

Activity scheduling allows a patient to identify activities that encourage positive behavior, and work them into their daily schedules. Activity scheduling can support patients recovering from alcohol use disorder (AUD) by avoiding activities that trigger negative emotions and may trigger a relapse. Scheduling activities ensures that patients fill their time with activities that encourage positive emotions.

Problem-Solving 

This therapy teaches patients how to manage stressful events, situations, and specific problems that occur in their lives, such as chronic illness, relationships, work pressures, and major events. This technique can help patients with alcohol use disorder (AUD) by mitigating their dependency on alcohol as a coping mechanism and encouraging healthier methods of dealing with problems.  

Successive Approximation

Also called shaping, is a method of shaping behavior by reinforcing positive behaviors in small increments, or approximations. This can be used to successfully treat alcoholism by rewarding abstinence from alcohol in gradually increasing increments, which eventually reinforces long-term abstinence.

Mindfulness & Breathing Skills

Many mental health professionals encourage relaxation and breathing techniques in their cognitive behavioral therapy (CBT) programs. These practices are a form of self-help and provide many positive mental health benefits. These techniques can help patients with alcoholism relieve stress and improve their overall well being, which can help curb the desire to abuse substances. Breathing exercises have also been proven to treat depression, which is a contributing factor to alcohol addiction.

How Much Does CBT Cost?

The cost of cognitive behavioral therapy (CBT) for treating alcoholism depends on a variety of factors, including location, the number of sessions required, length of sessions, and the type of therapist (pre-licensed vs. licensed CBT therapists). Most patients will meet with a CBT therapist between five and 20 weekly and biweekly sessions, with the average cost of each session between $140 and $290.

Most health insurance covers some alcohol treatment, which can include CBT. You can find out if your insurance covers this type of therapy for alcoholism and what behavioral therapists are in-network by contacting your insurance company. 

For those needing financial assistance, some CBT therapists or programs offer payment assistance or a sliding scale fee, or reduced pricing based on the patient’s income.

Resources

Carroll, Kathleen  M., et al. “Computer-Assisted Delivery of Cognitive-Behavioral Therapy for Addiction: A Randomized Trial of CBT4CBT.” Psychiatry Online, American Journal of Psychiatry, 1 July 2008, ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2008.07111835.

Carroll, Kathleen M, and Lisa S Onken. “Behavioral Therapies for Drug Abuse.” The American Journal of Psychiatry, U.S. National Library of Medicine, Aug. 2005, www.ncbi.nlm.nih.gov/pmc/articles/PMC3633201/.

Chien, Hui-Ching, et al. “Breathing Exercise Combined with Cognitive Behavioural Intervention Improves Sleep Quality and Heart Rate Variability in Major Depression.” Journal of Clinical Nursing, U.S. National Library of Medicine, 25 Sept. 2015, pubmed.ncbi.nlm.nih.gov/26404039/.

“Cognitive Behavioral Therapy - Part 1 - An Overview.” Substance Abuse and Mental Health Services Administration, www.samhsa.gov/sites/default/files/programs_campaigns/samhsa_hrsa/cognitive-behavioral-therapy.pdf.

Dotinga, Randy. “Cognitive Therapy Helps Depressed Drug Abusers.” HealthDay News, Consumer HealthDay, 6 June 2011, consumer.healthday.com/general-health-information-16/alcohol-abuse-news-12/cognitive-therapy-helps-depressed-drug-abusers-653565.html.

Dozois, David J. A. “Understanding and Enhancing the Effects of Homework in Cognitive‐Behavioral Therapy.” Wiley Online Library, John Wiley & Sons, Ltd, 8 June 2010, onlinelibrary.wiley.com/doi/abs/10.1111/j.1468-2850.2010.01205.x.

Magill, Molly, and Lara A Ray. “Cognitive-Behavioral Treatment with Adult Alcohol and Illicit Drug Users: a Meta-Analysis of Randomized Controlled Trials.” Journal of Studies on Alcohol and Drugs, U.S. National Library of Medicine, July 2009, www.ncbi.nlm.nih.gov/pmc/articles/PMC2696292/.

 

McHugh, R Kathryn, et al. “Cognitive Behavioral Therapy for Substance Use Disorders.” The Psychiatric Clinics of North America, U.S. National Library of Medicine, Sept. 2010, www.ncbi.nlm.nih.gov/pmc/articles/PMC2897895/.

National Institute on Drug Abuse. “Behavioral Treatments Increase Brain Activity Related to Cognitive Control.” National Institute on Drug Abuse, 8 May 2020, www.drugabuse.gov/news-events/science-highlight/behavioral-treatments-increase-brain-activity-related-to-cognitive-control.

“Psychotherapy.” NAMI.org, National Alliance on Mental Illness, 2020, www.nami.org/About-Mental-Illness/Treatments/Psychotherapy.

“What Is Problem-Solving Therapy?” div12.Org, American Psychological Association Division 12, www.div12.org/sites/default/files/WhatIsProblemSolvingTherapy.pdf.

Updated on: August 28, 2020
Author
Alcohol Rehab Help Writing Staff
About
Medically Reviewed: August 26, 2020
AnnaMarie Picture
Annamarie Coy,
BA, CADACII/ICADC, ICPR, MATS
About
All content created by Alcohol Rehab Help is sourced from current scientific research and fact-checked by an addiction counseling expert. However, the information provided by Alcohol Rehab Help is not a substitute for professional treatment advice. For more information read out about us.
© 2020 by Treatment Pathway LLC. All right reserved.