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Change Your Thoughts, Change Your Addiction: CBT for Alcoholism

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Cognitive-behavioral therapy (CBT) is a type of talk therapy provided by mental health professionals to help treat various conditions, including addiction. In CBT treatment, therapists work with you to help you recognize how your thoughts, behaviors, and feelings interact with your experience of the world.2

What is Cognitive-Behavioral Therapy (CBT)?

This approach is taken for a few reasons. First, people often hold on to false or distressing beliefs about things that happen to or around them.1 By recognizing the connection between what a person thinks, feels, and behaves, people can have a better understanding of their overall well-being and what things they would like to change to be happier and healthier.2

Holding on to negative thoughts or behavior patterns often leads to self-fulfilling prophecies2—the ways you expect things to happen—which in turn affects the way you behave, which then results in your original expectation coming true. For example, if you see the world through a negative lens, life will feel more negative and thus will be more difficult. By learning how to replace negative thoughts/behaviors with more realistic and positive ones, you learn to feel and react to things more clearly.1

Secondly, cognitive behavioral therapy focuses on the present moment, which is different from other types of therapies.2 Therapists work with addicts to recognize distressing thought and behavior patterns in the here and now, and then helps you to unlearn the thoughts and behaviors that are not serving you. To support you in this, several interventions may be used that are designed to teach you how to cope in a healthier and more effective way.2

Of course, your past experiences are important and will be taken into account by the therapist during therapy. However, CBT is unique in that it focuses on learning helpful skills and applying them to present-moment situations, which helps to set you up for long-term success in your recovery from alcohol addiction.1

Some people find that solely attending CBT sessions with a therapist is helpful, while others find it is best when combined with other therapies.2 Whatever approach is taken, CBT has been shown to be helpful for a range of mental health conditions including anxiety, depression, and addiction, among others.1

CBT to Treat Alcoholism

Alcohol use disorder is extremely common across the world and in the U.S. in particular, with an estimated 5.6% of all adults aged 18 and older struggling with alcohol use disorder in 2019.8

As human behavior is learned, people tend to develop behavioral patterns that they repeat over and over again throughout their lifetime.1 When you rely on alcohol as a coping mechanism or form of distraction or avoidance, it becomes an unhealthy behavior pattern that often requires time and healing to unlearn.2

Cognitive behavioral therapy is very successful for this very reason, as the underlying philosophy is that people tend to develop unhealthy thoughts or behavior patterns that might feel easy or good at the moment but ultimately make life harder than it has to be.2 Through recognizing these thoughts and behaviors and then actively working to change them, you can live a healthier life.1

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Problem Solving

At its core, cognitive behavioral therapy is designed to be problem-solving. Mental health providers work with you to help you learn healthier coping skills and alternatives to thoughts/behavior patterns that interfere with your overall well-being, i.e., your drinking habits. Individualized, concrete skills are taught that help you work through any patterns you have developed.

For these reasons, cognitive behavioral therapy has been successful in the treatment of alcohol use disorder.3 Ultimately, through CBT, you will be able to:6

  • Gain more insight into yourself
  • Address any emotional issues that are making life hard
  • Learn healthy, useful coping skills to help keep you alcohol-free

Cognitive behavioral therapy teaches you behaviors to replace drinking, such as:3

  • Ways to strengthen relationships with others
  • Ways to strengthen the relationship you have with yourself
  • Healthy coping strategies for high-risk situations

The underlying principles of CBT are what makes it uniquely suited for treating substance use disorders, including alcoholism. For example, those with alcohol use specifically tend to have a hard time with self-efficacy (whether they can perform a behavior correctly). Alcoholics often feel as though it is difficult to stop drinking or that it’s impossible for them. Cognitive behavioral therapy works to teach those struggling with alcohol use how to be more self-efficient. This is done through talk therapy in addition to healthy coping skills training. Evidence has shown that the problem-solving approach taken in CBT treatment significantly decreases a person’s likelihood of relapse.4

As a result of the structure of CBT and the ways in which it is uniquely suited for those struggling with alcohol use disorder, it is often used in the treatment of alcoholism. You may receive cognitive behavioral therapy at your rehab or treatment program or may rely on CBT as a useful tool as you navigate the transition after being released from rehab.

If you receive naltrexone (medication used to reduce alcohol cravings) treatment, you can also benefit greatly from CBT treatment.4 Studies have shown that individuals who receive a combination of naltrexone and CBT treatment are at a much lower likelihood of relapsing because the medication works to reduce cravings, while the CBT helps give people the skills they need to remain substance-free.4

When is CBT Recommended?

Treatment for alcohol addiction looks different depending on the program. Many treatment programs for alcohol use focus on explaining why people should abstain from drinking alcohol. However, these programs often do not train you in the necessary skills they need to avoid drinking, such as healthier coping methods for stressful situations.3

Behavioral treatment in the form of counseling is often one aspect of rehab, especially rehab for individuals learning emotional regulation and habit building skills, such as individuals with dual diagnoses and teenagers with alcohol use disorder. Cognitive behavioral therapy may be provided, but other types of therapy are often used, such as:

While some rehabilitation and outpatient programs may not have cognitive behavioral therapy embedded in their treatment model, it is commonly used in the treatment of substance use. If cognitive behavioral therapy seems like a good fit for you and is not currently being offered by your treatment provider, ask your physician or healthcare provider to refer you to a CBT-trained therapist within your insurance network.

Some cognitive behavioral therapists also see patients who do not have health insurance through the use of a sliding scale (where patients pay what they can, depending on their income). To find alcohol rehab options and talk about CBT for your recovery, call 800-948-8417 Question iconCalls are forwarded to these paid advertisers to find help today.

How Effective is Cognitive Behavioral Therapy?

Cognitive behavioral therapy is extremely effective in the treatment of mental health conditions,1 including alcohol use disorder. Individuals with alcohol use disorder often find that CBT greatly increases their chances of remaining sober and living happy, healthy lives.3 However, it is important to remember that it is not a quick fix.

To get the most from CBT treatment, you need to cooperate fully with the process. Benefits may not appear right away, because emotional issues first need to be addressed before they can be fully worked through.6 After this process is underway, people often find the coping skills they develop through CBT are useful in both the present and in the long-term.6

CBT Techniques: What to Expect

Cognitive behavioral therapy is a type of talk therapy during which you work directly with a mental health provider, such as a therapist, in a structured way.1 You can expect to attend a set number of one-hour sessions (16 on average), depending on your treatment needs and goals.6 At first, CBT helps you to become more aware of any negative thinking you have and helps you notice behavioral patterns you often find yourself in.1

Once these patterns are addressed, thoughts and behaviors are challenged and you are taught to approach situations in a more positive way.6 By giving you the skills to change the way you think and behave, you can shift your perspective during challenging situations and respond more effectively.1

There are many cognitive behavioral therapy techniques that a mental health provider may use in treatment for alcoholism. This type of therapy is unique in that the relationship between the patient and the therapist is collaborative, and you are treated as an expert in your own life.6 As a result, different therapeutic tools may be used depending on your individual needs. For example, if you use alcohol to relax from stress you may be taught mindfulness or relaxation skills, such as breathing exercises to help relax the body.

“Homework” such as practical exercises or writing assignments may be used to help reinforce tools being learned in therapy between sessions.6

Your First Session

When you begin individual CBT, there are a few things you can expect. At the first session, a therapist will ask a lot of questions to gather information about you and what your treatment goals are. It is important for mental health providers to get a good understanding of your physical and mental health history in addition to any other current concerns you may have.2 By gathering information and getting to know you, the patient, a CBT provider can then work with you to figure out how to best meet any treatment goals.2

At the first session, it is also important for you to decide whether the therapist is a good fit for you. This might depend on a number of things, such as what their approach is and what your own treatment goals are. It is important to feel comfortable with a therapist so you can get the most out of therapy.2

As with all therapy, some discomfort may arise when discussing current emotions, experiences, and struggles with alcohol use. While the CBT process may be unpleasant at times, it will help you work through your emotional problems and give you concrete coping skills that you can use for the rest of your life. As a result, in the end, you should feel healthier, happier, and better prepared to navigate any difficulties in your life.2

For more information about CBT treatment and rehab options, call 800-948-8417 Question iconCalls are forwarded to these paid advertisers today.


1. U.S. National Library of Medicine. (2013, August). Cognitive behavioral therapy.
2. Mayo Clinic. (2019, March). Cognitive behavioral therapy.
3. U.S. National Library of Medicine. (2008, October). Cognitive-behavioral therapy for alcohol and drug use disorders.
4. Anton, R., Moak, Darlene, H., Latham, P., Waid, L., Myrick, H., Voronin, K., Thevos, A., Wang, W., Woolson, R. (2005). Naltrexone Combined With Either Cognitive Behavioral or Motivational Enhancement Therapy for Alcohol Dependence. Journal of Clinical Psychopharmacology, 24(4), 349-247.
5. National Institute on Alcohol Abuse and Alcoholism. (N.D.). Rethinking Drinking: Alcohol & Your Health.
6. Good Therapy. (2018, June). Cognitive Behavioral Therapy (CBT).
7. National Health Service. (2014). Cognitive behavioural therapy (CBT).
8. National Institute on Alcohol Abuse and Alcoholism. (2020, October). Alcohol Facts and Statistics.
9. National Institute on Alcohol Abuse and Alcoholism. (1991). Alcoholism and Co-Occurring Disorders.

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