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Cognitive Behavioral Therapy for Alcoholism

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What Is Cognitive Behavioral Therapy (CBT)?

Cognitive behavioral therapy (CBT) explores the link between thought patterns and addiction.

It's a proven treatment for alcohol use disorder (AUD), both on its own and in combination with other treatments. 

CBT is also known as a short-term therapy technique. That's 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 therapy because it focuses on the attitudes which drive addiction. It seeks to replace negative behavior or thought patterns with healthy ones.

CBT helps those with alcoholism understand those harmful patterns and learn coping mechanisms to prevent them.

What Are the Three Goals of Cognitive Behavioral Therapy?

There are three objectives with CBT:

  • Change negative thinking patterns
  • Discourage unhelpful behavior patterns
  • Teach coping strategies
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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 other than those of other therapies.

CBT is an effective treatment for many mental health conditions as well.

These 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

CBT is also more effective for relapse prevention when used in combination with medication. 

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

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 be used to help someone apply what they’ve learned and build new positive habits.

For those 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.

By safely exposing someone to their triggers, it can allow them to process the resulting feelings.

Activity Scheduling 

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

Problem-Solving 

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 be used to treat alcoholism by rewarding abstinence in slowly increasing increments.

Mindfulness & 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.

This, in turn, can help curb the desire to abuse substances.

Breathing exercises have also been proven to treat depression, which is a risk factor for alcoholism.

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How Much Does CBT Cost?

The cost of CBT for alcoholism depends on a variety of factors.

These include:

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

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

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 those needing financial assistance, some CBT therapists offer payment assistance based on the patient’s income.

Updated on March 29, 2022
9 sources cited
  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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.
  7. National Institute on Drug Abuse. “Behavioral Treatments Increase Brain Activity Related to Cognitive Control.” National Institute on Drug Abuse, 8 May 2020.
  8. Psychotherapy.” NAMI.org, National Alliance on Mental Illness, 2020.
  9. What Is Problem-Solving Therapy?” div12.Org, American Psychological Association Division 12.

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