Cognitive Behavioral Therapy

One of the most common types of treatment used in alcohol and drug treatment centers is called cognitive-behavioral therapy (CBT). The Ranch at Dove Tree uses this and other evidence-based therapies because they have been scientifically proven to help people suffering from substance use disorder. CBT is a form of talk therapy in which a person discusses specific concerns with a mental health counselor.

What are the Origins of Cognitive Behavioral Therapy?

CBT was developed in the 1960s by psychiatrist Aaron Beck. Beck noticed that his clients were saying things about themselves or their situations that had little validity. He called these thoughts “cognitive distortions,” and he came to believe that these errors in thinking were primarily responsible for disorders like depression and anxiety. If a therapist could help clients become aware of their thought patterns and learn to distinguish valid from invalid thoughts, they could also help clients learn how to think (and thus behave) in more positive ways. 

Cognitive behavioral therapy, as it came to be known, focuses on three types of thoughts: automatic thoughts, cognitive distortions, and underlying beliefs. 

  • Automatic thoughts are those thoughts we have that are immediate and reflexive, often in response to events. Without even realizing we’re doing it, we interpret events in ways that are usually negative. 
  • Cognitive distortions are specific ways our thoughts can be illogical. For example, one type of cognitive distortion is called overgeneralization, which occurs when we make wide generalizations based on an isolated incident. I failed this test, so I’ll probably fail all my tests in this class. I’m not smart enough for this subject.  
  • Underlying beliefs include our core assumptions about how the world operates and who we are in it. Negative underlying beliefs might include things like, The world is dangerous. People can’t be trusted. I am unlovable

What Is the Goal of CBT?

The main goal of CBT is to help people with negative thought processes recognize when their automatic thoughts are negative, what types of cognitive distortions they engage in, and what underlying beliefs motivate their attitudes and behaviors. The more a person can recognize negative thoughts and understand their tendencies, the better able they are to intervene and change course. Changing one’s thoughts about a situation changes how one responds to it, therefore reducing negative outcomes.

Most often, CBT is used alongside other types of evidence-based therapies, experiential therapy, and holistic treatment. It’s often used in individual sessions but can also be done in some group settings.

When Is Cognitive Behavioral Therapy Used?

It’s up to a mental health provider to decide when to use CBT with a person suffering from a mental illness or a substance use disorder. CBT is commonly used with people who have an addiction, depression, eating disorders, or post-traumatic stress disorder.

When used properly, CBT can help a person to recognize the presence of a problem or a negative thought process and then cope with the challenge in a better manner. For example, a person with intense stress and depression may find themselves moving through the day with negative thoughts. Something simple happened, such as being late to work. That leads to self-deprecating thoughts, including feeling stupid for not remembering a meeting. Throughout the day, the person continues to beat themselves up, until they are frustrated and overwhelmed. In some situations, this may lead the person to drink or use drugs to cope.

Correctly applied, CBT offers a number of benefits. For example, it may help a client:

  • Learn how to manage symptoms of a mental illness, such as anxiety or depression
  • Treat mental illness itself when medications are not desired or are ineffective
  • Learn to manage emotions in a positive manner
  • Manage chronic physical symptoms
  • Avoid using drugs or alcohol as a solution to problems
  • Overcome trauma, including emotional trauma
  • Manage conflict and improve communication skills

Mental health professionals may encourage CBT when they want to empower a person to take charge of their thoughts to create a better outcome.

What Happens During Cognitive Behavioral Therapy?

After you meet with a therapist and create a treatment plan, you can expect to have at least one CBT session a week for a few weeks or months. Unlike traditional psychotherapy, CBT is goal-oriented and has a defined end point. 

During the first session, your therapist will spend some time gathering information about you and talking about things you want to work on. You may be asked to describe, as you’re comfortable, past and current emotional or physical trauma that need to be addressed. However, the focus will be on the behaviors you want to change. Maybe you want to stop your compulsive behavior or feel less anxiety or learn how to feel more confident at work. With your therapist, you’ll set goals for yourself that you can use as checkpoints throughout your time in therapy. 

During the actual therapy session, your counselor will talk to you about your thoughts and feelings and help you gain the confidence to control your thoughts and emotions. Your therapist will guide your thought processes, showing you how making key changes in the way you think can impact the outcome.

The therapy process includes:

  • Identifying a troubling condition.
  • Becoming aware of your thoughts and emotions about that condition or event.
  • Becoming aware of your underlying beliefs that may affect your behavior. 
  • Recognizing negative thinking or inaccurate beliefs.
  • Reshaping those thoughts or beliefs to be more accurate.

Most people will have some homework to do during their time in CBT. Between sessions, you’ll need to work on learning to change automatic negative thought processes into better ones. It is not easy to do, but the results can be life-changing. Journaling can be a helpful technique for reflecting on your thought patterns and reactions to events and triggers. Your therapist may also ask you to practice relaxed breathing or progressive muscle relaxation to help ease your automatic stress response to certain situations. 

As you become more practiced at soothing yourself and shifting your thought patterns, your therapist may ask you to engage in mild exposure therapy, in which you purposefully expose yourself to things that trigger your negative or stressed reaction so that you can then examine the thoughts that arise and redirect them. 

Cognitive-behavioral therapy is often used in conjunction with other types of therapies, but even on its own, it can be an excellent tool in treating mental health and substance use disorders.  For many people, CBT is the component of drug and alcohol treatment that allows them to gain more control over their future. You’ll be empowered to make better decisions for yourself no matter what’s happening around you. 

Our team in Lubbock, Texas, is well versed in cognitive behavioral therapy, and it’s a core component of our residential, partial care, and outpatient treatment programs. Using CBT and other therapeutic modalities, we provide you with the tools you need to maintain sobriety and health once treatment ends.