What is Cognitive Behavioural Therapy (CBT)?

Cognitive behavioural therapy or CBT is a type of psychotherapy that focuses on modifying thought patterns and attitudes to facilitate a change in behaviour (Medical News Today).

CBT works on the basis that the way we think about things has a direct influence on the way we feel and behave. Because CBT is problem-focused, it requires clients to actively participate in sessions to help them overcome challenges and achieve their goals. Therapy will teach individuals how to solve problems on their own and one find constructive ways of coping with difficulties. Through a process of challenging negative thoughts and consequent destructive behaviours, CBT is the foundation for treating chronic stress, grief, and addiction.

How Does CBT Work?

CBT is a collaborative therapy in which a practitioner will focus on the meanings that people attach to events and the problems that unhelpful ways of interpreting these events can cause in their lives.

CBT works by assisting individuals with the following:

  • Identifies unhelpful thoughts and attitudes by defining problems.
  • Challenges factual versus irrational thoughts.
  • Helps individuals look at a problem or challenge from another perspective.
  • Works with clients to create adaptive and positive ways of thinking.
  • Helps set realistic goals.
  • Facilitates self insight and responsibility.

How Does CBT Help with Addiction?

CBT is based on the premise that addiction is worsened by dysfunctional ways of thinking. These negative thought patterns compromise recovery from addiction because individuals have self-defeating attitudes, false belief systems, or their negativity makes it difficult to cope with stress or challenges and triggers addictive patterns of behaviour.

To help individuals affected by addiction, CBT aims to change disruptive thought processes. When positive or helpful ways of thinking are introduced, it creates positive behaviours and the ability to cope with stress (NCBI).

A cognitive behavioural therapist will work closely with clients to explore negative or dysfunctional thoughts and its contribution to addiction. In treatment, your therapist will target unhelpful thoughts and attitudes and ultimately break the cycle of addition. Treatment is meant to empower you to feel confident about your strengths and to overcome the dysfunctional behaviours that are preventing your recovery.

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How Can I Take Part in CBT?

Because CBT is known as a talk therapy, it requires active involvement to overcome poor thinking patterns that influence how you feel and prevent you from achieving your goals.  CBT can include one-on-one therapy or group sessions and requires your input for therapists to understand your viewpoints and how you interpret events or challenges. Your therapist will create a strategy to improve negative ways of thinking or address the feelings that are holding you back. Let’s take a closer look at the ways you can effectively participate in CBT.

Within a Rehab Facility

CBT can be delivered individually or within a group as part of a residential programme within a private rehab facility. You will work with your CBT therapist on a daily basis (or as determined by the practitioner) to identify the source for dysfunctional thought patterns. Through homework and CBT techniques, you can create a positive mindset while working through self defeating attitudes and perceptions. The benefit of inpatient CBT is the opportunity to practice CBT skills in a safe environment and to have the support of your therapist.

With a Private Therapist

Private CBT is conducted as one-on-one sessions in which you talk about your fears, your goals, and your assumptions. The direction for therapy depends on the type of CBT that is adopted by the therapist. In Guided CBT, therapists will ask for your viewpoint on a particular matter. It is up to you to be honest about your opinions (Healthline). They will ask questions concerning your thoughts and beliefs with the purpose of introducing new perspectives that help you think “outside of the box.”

Through an NHS Outpatient Service (GP Referral)

Cognitive behavioural therapy can be accessed via a free NHS service. Speak to your GP about your concerns with addiction and ask them to refer you for CBT sessions.

The Pros and Cons of CBT

CBT remains the foundation for therapy when treating substance and behavioural or mental health addictions. To best understand its role in managing addiction, we look at the pros and cons.


CBT helps to “retrain your brain.” This includes identifying unhelpful thoughts and introducing strategies to problem-solve and learn new perspectives and habits. To help you learn new and constructive ways of thinking, a therapist may ask you to write you’re your most pressing negative thoughts or perceived failures and then discuss the reasons for these limiting beliefs and how it influences your behaviour during treatment.

A therapist will try to determine the cause for negative thinking. They may ask you to share your viewpoint on a topic or life event and then challenge this viewpoint. The purpose of this task is to help you see things differently and create new perspectives (M1 Psychology).

Because CBT can be clinically evaluated, it is considered among the most effective therapies for addiction and mental health conditions such as stress and anxiety.

It is a short-term therapy averaging 20 sessions and is talk-based which requires the active participation of clients. It is considered a natural and safe approach to treatment.

Cognitive behavioural therapy is considered consistent with the model of psychiatry in which symptoms are managed and marked improvements in function are achieved (NCBI Efficacy of Cognitive Behavioural Therapy). It achieves these results by making individuals an active participant in their treatment and recovery. A patient must partake in problem solving strategies in which dysfunctional thoughts are challenged with the purpose of modifying behaviour.

Because CBT is structured, it can be delivered in-person (private or group therapy), computer based interventions, and self help books (The CBT Clinic).

The skills you learn in CBT can be applied to your everyday life. It is a practical approach to learning new things and coping with stress long after you have completed therapy.

CBT is collaborative which allows the therapist and the client to work on realistic goals that individuals can achieve by breaking down their negativity and learning how to apply coping strategies in daily life (Healthcentral).



CBT is not recommended for individuals with learning disorders or complicated mental health disorders. This is because of its narrow focus which does not consider family history, previous trauma, childhood events, and various emotional problems (Healthcentral).

Studies involving CBT techniques proved more effective in the management of substance use disorders such as cannabis addiction; however, as a single therapeutic approach, it provides small to medium results in the treatment of opioid and alcohol dependence (NCBI – Efficacy of Cognitive Behavioural Therapy).

As CBT requires active involvement to be successful, the onus is on the client to engage in therapy and attend regular sessions. You have to be a part of solving problems and learning new habits.

Jason Sheirs
Author / Jason Shiers / Dip. Psych MBACP
Jason Shiers is a Certified Transformative Coach & Certified Psychotherapist who is a specialist in addiction, trauma and eating disorders. He has been working in the field of addiction for 25 years now.