Ralph Waldo Emerson once said, “If I have lost confidence in myself, I have the universe against me.” This is a concept that tends to come to the forefront in addiction therapy programs and mental illness treatment programs. Addiction and mental illness tend to rob those who struggle of the ability to think clearly, make good decisions, feel confident about the future and make healthy choices. While the consequences of these conditions can be serious, the right treatment program can restore confidence and the ability to think clearly. Cognitive Behavioral Therapy is one such treatment.

Becoming a Detective

Unlike traditional psychoanalysis where the patient plays a passive/listening role, Cognitive Behavioral Therapy (CBT) requires active participation from the person in treatment. During CBT sessions, patients and their therapists develop theories and think of new ways to change old habits that are then tested in real life.

According to the Association for Behavioral and Cognitive Therapies, CBT is designed to help people determine what is supporting poor behavior and what needs to change for that behavior to stop. CBT is often called a “targeted therapy” for this reason. While prior trauma, childhood issues or other triggers may have had a role to play in the start of the behavior, the emphasis is on what is happening right now.1 The sessions tend to move quickly, and often bring results in a short period of time.

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Structure is Key

In order for the therapy to begin working, CBT sessions are highly structured. Instead of talking about the week or a patient’s reactions to old stimuli in a free-form manner, the sessions use the following format:
  • A brief mood check
  • A review of the last session’s work
  • Setting an agenda for the session
  • A review of the week’s homework
  • Patient outlines challenges coming up in the next week
  • Therapist and patient develop strategies to handle those challenges
  • Patient is assigned homework based on listed challenges
  • Session ends2
According to the Mayo Clinic, CBT sessions may last only 45 to 60 minutes, but the assigned homework takes much longer to complete. The homework plays a key role in the effectiveness of CBT.1

A New Way of Thinking

During addiction treatment it is important to help the person struggling understand the causes for drug relapse. CBT encourages people to break apart a relapse, looking for relapse triggers and when resistance began to fade. When a person can identify these factors, the rehab team can develop strategies to help the person avoid them in the future. People who have numbed their minds with drugs and alcohol may have difficulty dealing with powerful emotions like grief, anger or loss. The person in treatment may have no idea how to deal with the rising tide of emotion, and the temptation to use again becomes overwhelming. CBT teaches mindfulness techniques that allow those in recovery to live in the moment and recognize the pain they feel now will dissipate with time. Some therapists provide lessons in meditation or muscle relaxation, encouraging their patients to use these techniques when deep emotions tend to overwhelm. CBT is also used to treat depression and other forms of mental illness. According to the National Alliance on Mental Illness, people who receive CBT do better in treatment than patients who do not. CBT has also been effective in treating other mental illnesses such as:
  • Social phobias
  • Personality disorders
  • Eating disorders
  • Psychotic disorders
People who struggle with mental illnesses and substance abuse also benefit from CBT.  Patients with these co-occurring disorders learn to control their symptoms without turning to drugs or alcohol.

CBT is often combined with medication management for those recovering from addiction to drugs like heroin or other opioids. Because opioids cause both a physical and psychological dependence, combining medications and CBT is often the best way to help these people improve.

CBT Treatment Approaches

CBT is an individualized approach to treatment for mental illness and addiction. Putting the patient in control over how much of the treatment is delivered and how success is measured can be one of the greatest benefits of this treatment approach. If you’d like to learn more about how CBT can help you or a loved one recover from addiction or mental illness, contact us at Michael’s House. Our admissions coordinators are available to take your call 24 hours a day.
Sources 1 “Cognitive Behavioral Therapy.” Mayo Clinic, Mayo Foundation for Medical Education and Research. 29 Dec. 2017. 2 Weinstock, Marjorie. “Staff Perspective: CBT for Depression – Elements of Session Structure.” Center for Deployment Psychology. 24 June 2016.

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