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Alcohol & Health
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Updated on October 26, 2023
7 min read

Cognitive Behavioral Therapy for Alcoholism

Alcoholism, also known as alcohol use disorder (AUD), can be treated in various ways. Although some cases have genetic causes, it’s a condition that also develops due to environmental conditions and other co-occurring illnesses. 

Cognitive behavioral therapy (CBT) is one of the many potential treatments for alcoholism. This blog covers its different aspects to determine if it’s the right recovery method for you.

What Is Cognitive Behavioral Therapy (CBT)?

Cognitive behavioral therapy (CBT) explores the link between thought patterns and addiction. Cognitive behavioral therapists identify and challenge negative thought patterns and behaviors in patients to improve mental health.

People dealing with substance use disorders can alleviate various psychological conditions by altering dysfunctional thought processes and adopting healthier behavior.

There are multiple approaches to CBT treatment:

  • Cognitive therapy: Targeting and addressing negative thoughts, aiming to replace distorted or unhelpful behaviors.
  • Dialectical behavior therapy (DBT): Emphasizing acceptance and mindfulness for emotional regulation.
  • Rational behavior therapy: Changing irrational beliefs and maladaptive behaviors through problem-solving.
  • Rational emotive behavior therapy (REBT): Identifying and challenging irrational beliefs by studying the connection between negative thoughts and emotional distress.
  • Rational living therapy: Developing rational and balanced life perspectives through broader life philosophy principles.

CBT is a proven treatment for AUD, both on its own and in combination with other treatments. It’s a short-term therapy technique that typically requires only twelve sessions or less to notice results.


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How Does CBT Work?

CBT works by focusing on the attitudes that drive addiction. It seeks to replace negative behavior or thought patterns with healthy ones through these methods:

  • Functional analysis: Patients learn to identify the causes and consequences of a specific behavior or habit. During functional analysis, therapists may ask the patient what they thought or felt before, during, and after using a substance. By identifying the situations where an individual might engage in problematic behavior, they can develop better self-management skills.
  • Skills training: Substituting negative behavioral patterns with positive and enduring actions like exercise and mindfulness is imperative to treating alcohol use disorder.

What Are the Goals of Cognitive Behavioral Therapy?

CBT helps people with alcoholism understand harmful patterns and learn coping mechanisms to prevent them. It aims to achieve the following goals:

  • Improve self-control
  • Avoid triggering circumstances
  • Develop healthy coping skills
  • Recognize situations in which someone is likely to engage in drug or alcohol use
  • Cope with other problems and behaviors that may lead to substance abuse

Besides aiding in alcoholism recovery, CBT can also be applied to mental illnesses and other substance disorders.

Does Alcoholics Anonymous Use Cognitive Behavioral Therapy?

Support groups like Alcoholics Anonymous (AA) share techniques with CBT. For example, there are ways to implement the AA 12-step programs from a CBT perspective.

Step One: We admitted we were powerless over alcohol – that our lives had become unmanageable.

In a cognitive therapy setting, a person might admit and accept the compulsive nature of the disease, recognizing its symptoms and consequences.

Step Six: We were entirely ready to have God remove all these defects of character.

People in Step 6 of the AA program must identify ineffective character traits like aggressive behavior, over-compliance, and manipulation as a coping mechanism for alcohol use disorders.

Step Eight: We made a list of all the persons we had harmed and became willing to make amends to them all.

People in step eight of the AA program extensively review how they might’ve hurt loved ones in their history of alcohol and drug use. Afterward, they create a plan to make amends to the people they’ve harmed.


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Types of Cognitive Behavioral Therapy Techniques

Here are some techniques used by CBT therapists:

Cognitive Restructuring 

This type of talk therapy allows patients to notice and change negative thinking patterns or cognitive distortions.

When used to treat alcoholism, cognitive restructuring allows the person to be aware of unhelpful thinking patterns. It can also help patients to re-wire negative beliefs about abstinence.

Behavioral Assignments 

Also called homework assignments, these may help someone apply what they’ve learned and build new positive habits.

For people overcoming alcoholism, homework assignments can help them remember what they learned in therapy. They can also apply the techniques outside of therapy when facing triggers.

Research shows that the completion of these assignments leads to better treatment outcomes.

Exposure Therapy 

This involves exposing the patient to their cues for substance abuse in a safe, controlled environment.

Triggers are naturally removed to prevent cravings and relapse, especially for people undergoing inpatient treatment. However, safely exposing someone to their triggers can allow them to process the resulting feelings.

Activity Scheduling 

Activity scheduling involves incorporating positive activities into your daily life. Recovering alcoholics use it to avoid activities that trigger negative feelings.


This teaches patients how to manage stressful situations that occur in their lives. These can include things such as chronic illness, relationships, work pressures, and major events.

It helps people reduce their alcohol dependency and find healthier responses to problems.

Successive Approximation

This involves reinforcing positive behaviors in small increments or approximations.

It can treat alcoholism by rewarding abstinence in slowly increasing increments.

Mindfulness and Breathing Skills

Mental health professionals encourage relaxation and breathing techniques in their CBT programs. These practices are a form of self-help and provide many positive mental health benefits. They can help those with alcoholism relieve stress and improve their overall well-being.

Staying stress-free and at peace makes it easier to curb their desire to depend on substances. Breathing exercises have also been proven to treat depression, which is a risk factor for alcoholism.


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How Effective is CBT for Alcohol Abuse?

Research shows that CBT effectively treats alcohol addiction when paired with additional treatments, such as a standard outpatient program or alcohol counseling. Its results are also longer-lasting than those of other therapies.

CBT is an effective treatment for many mental health conditions, which include:

  • 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

Another study found that patients who received CBT had fewer drinking days.

While CBT can work as a standalone treatment for substance abuse, it’s more productive alongside other treatment strategies like group therapy sessions. CBT is also more effective for relapse prevention when combined with medication.

How Long Does it Take for Cognitive Behavioral Therapy to Work for Alcohol Addiction?

CBT is a structured and goal-oriented addiction treatment that occurs short-term and can be completed within 12 to 16 sessions.

However, the duration of addiction treatment may vary according to the severity of the drug addiction and the presence of co-occurring problems like depression and anxiety disorders.

How Much Does CBT Cost?

Most people will attend between five and 20 weekly or biweekly CBT sessions. The average cost of each session is between $140 and $290.

The cost of CBT for alcoholism depends on several factors, which include:

  • Location
  • Number of sessions required
  • Length of sessions
  • Type of therapist (pre-licensed vs. CBT-trained therapist)

Most health insurance covers some alcohol treatment, which can include CBT. You can find out if your insurance covers CBT for alcoholism by contacting your insurance company.

For people who need financial assistance, some CBT therapists offer payment assistance based on the patient’s income.


Cognitive behavioral therapy is an effective alcohol treatment strategy, enabling people with alcohol addiction to identify and correct negative behavior patterns. Through CBT, people suffering from substance misuse can develop coping strategies and adaptive ways of thinking. 

CBT is a highly effective treatment for substance use disorders. It encompasses developing learning strategies, coping skills building, and motivational practices for improving one’s quality of life.

While CBT can be a great start to developing healthier habits toward recovery, it’s best used in conjunction with other treatment strategies. Consult your healthcare provider to determine which options work best for your condition.

Updated on October 26, 2023
8 sources cited
Updated on October 26, 2023
All Alcoholrehabhelp content is medically reviewed or fact checked to ensure as much factual accuracy as possible.

We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies.
  1. Carroll et al. “Computer-Assisted Delivery of Cognitive-Behavioral Therapy for Addiction: A Randomized Trial of CBT4CBT.” American Journal of Psychiatry, Psychiatry Online, 2008.
  2. Carroll et al. “Behavioral Therapies for Drug Abuse.” The American Journal of Psychiatry, U.S. National Library of Medicine, 2005.
  3. Chien 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, 2015.
  4. Dozois, D.J.A. “Understanding and Enhancing the Effects of Homework in Cognitive‐Behavioral Therapy.” Wiley Online Library, Wiley Online Library, 2010.
  5. Magill, M., and Ray, L.A. “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, 2009.
  6. McHugh et al. “Cognitive Behavioral Therapy for Substance Use Disorders.” The Psychiatric Clinics of North America, U.S. National Library of Medicine, 2010.
  7. Psychotherapy.” National Alliance on Mental Illness.
  8. What Is Problem-Solving Therapy?” American Psychological Association Division 12.
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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.
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