Cognitive behavioral therapy (CBT)

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is a type of psychotherapy. It is used to treat many psychological problems, including treating people for substance use disorder. CBT focuses on having the client identify and change their negative thoughts, with the idea that their behavior will improve.

History of Cognitive Behavioral Therapy

Aaron Beck developed CBT in the 1960s. Since that time, it has been used effectively in several studies treating the following:

• Anxiety
• Bipolar Disorder
• Depression
• Eating Disorders
• Schizophrenia
• Substance Abuse Disorder

Dr. Beck noticed that his patients living with depression often expressed that their thoughts weren’t valid. He noted that they had “cognitive distortions” in their thinking. Beck started viewing depression as a cognitive disorder (a disorder affecting the patient’s thinking) instead of a mood disorder.

Based on his observations, Dr. Beck outlined his cognitive theory about depression. He included cognitive, emotional, and behavioral components in what would become known as Cognitive Behavioral Therapy. Today, it is the “most extensively researched of all psychotherapies,” according to the National Library of Medicine. It is commonly used by many therapists due to its effectiveness.

CBT has been studied and adapted for children, teens, adults, families, and couples. It has been effective for all of these types of clients.

Cognitive Behavioral Therapy Basics

Cognitive behavioral therapy focuses on how someone’s thoughts can influence their mood. CBT is used to treat specific issues that a client is experiencing, such as:

• Cognitive distortions
• Dysfunctional automatic thoughts
• Underlying core beliefs

Cognitive Distortions. The human brain is constantly processing information. To cope with the amount of incoming information it receives, It looks for shortcuts to reduce its workload. This is where cognitive distortions come into play: they are internal mental biases that fuel anxiety and generally make a person’s self-esteem take a nose-dive.

Examples: “I didn’t get hired for that job I wanted. I’m a failure.”

“My last date was a disaster. I know I’ll never find someone.”

Dysfunctional Automatic Thoughts: An individual may need to examine them for evidence to support their interpretation to avoid negatively interpreting social situations. Some common automation negative thought patterns are:

• All or Nothing Thinking: A person sees things in black and white. If they perform less than perfectly, they feel they have failed.
• Jumping to Conclusions: The person interprets the situation negatively without any evidence to support their conclusion.
• “Should” Statements: People motivate themselves by using “should” and “shouldn’t” statements. If the individual can’t complete their tasks, they feel guilty. When someone who uses “should” statements with other people feels frustrated, angry, and resentful because the other person didn’t live up to their expectations. [Text Wrapping Break]

Underlying Core Beliefs. For CBT purposes, a person’s core beliefs are about themselves, others, and the world. People form assumptions and rules about how they should be and how they see the world based on their core beliefs. If the core beliefs are negative (“I’m no good,” “People wouldn’t like me if they found out what I’m really like,” ” The world is dangerous, and I need to be vigilant all the time.”) the person sees their environment through that view and expects things to go wrong for them.

How Cognitive Behavioral Therapy Works

CBT proposes that a person’s feelings impact their thoughts, which affect their behaviors. This theory is based on three fundamental beliefs:

1. An individual’s cognitive activity affects their emotions, affecting their behavior.
2. Their cognitive activity and emotions can be monitored and changed.
3. A positive behavior change can be achieved through changing one’s thoughts.

Benefits of Cognitive Behavioral Therapy

CBT helps clients in several ways. This type of therapy is meant to be delivered over a limited number of sessions to assist clients with stressful life issues they are currently experiencing.

1. CBT helps clients identify negative thinking.

One of the immediate benefits of cognitive behavioral therapy is that clients become aware of the negative thinking that influences their behavior.

These “hot thoughts” often come from messages they received as children from parents, teachers, or others. Hearing a particular word or phrase can immediately take a person back to when they first heard it. In their mind, they are a young, powerless child. Then that person may even behaving “as if” that child would by becoming upset, shutting down, etc. These automatic thoughts are that powerful.

The other thing that may happen is that the person wants to forget how they felt as a powerless child and may turn to chemicals to help. CBT for drug and alcohol addiction is effective since it allows the client to identify their negative thinking and offers alternatives to continuing to use drugs or alcohol.

2. CBT helps improve self-image.

A steady mental diet of negative thoughts eventually leads to low self-esteem for a person. Cognitive behavioral therapy changes negative thinking patterns and makes the client challenge their negative thoughts about themselves. They start to develop a more realistic self-image.

3. It helps develop new coping skills. 

Once clients have identified negative emotions, CBT helps them develop new coping skills to assist them in stressful situations. Working with their therapist, they may use any (or all) of the following:

• Cognitive restructuring
• Communication skills
• Goal management
• Journaling
• Mindfulness
• Self-monitoring

How CBT Helps with Drug and Alcohol Addiction

CBT can be a crucial part of the overall treatment plan for clients in recovery from substance use disorder. It helps them make connections between their thoughts, feelings, and actions and how they influence the mind. With time, clients learn how to throw out their “hot thoughts” and learn coping skills to manage stressful situations.

Negative thoughts are linked to depression and anxiety, which are often triggers for a slip or a full-on relapse for a person in recovery. CBT for alcoholism and drug addiction helps clients realize that the negative thoughts that lead to them drinking or using drugs are not facts. Instead, they are false beliefs. Clients learn communication skills and other ways to manage triggers to improve their mood and lower the risk of a relapse.

The Aviary Recovery Center offers CBT along with other therapies for the safe and effective treatment of substance use disorders (formerly called substance abuse). Our facility takes a holistic approach to addiction treatment that cares for the whole person. Cognitive behavioral therapy is part of a personalized recovery plan that allows clients to discover their strengths and build resiliency for long-term recovery.

Sources:

Types of Common Negative Thoughts: https://sdlab.fas.harvard.edu/cognitive-reappraisal/identifying-negative-automatic-thought-patterns

Core Beliefs: https://positivepsychology.com/core-beliefs-worksheets/#examples

CBT History: https://www.ncbi.nlm.nih.gov/books/NBK470241/