Understanding CBT In Addiction Recovery

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Understanding CBT In Addiction Recovery

By The Fix staff 12/18/17

You might have used Cognitive Behavioral Therapy in the past, but do you know how it works?

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psychological therapy
CBT helps recovering addicts by restructuring their harmful thought patterns and behaviors.

Cognitive Behavioral Therapy is one of the most popular treatment options for people who are in recovery from substance use disorder and co-occurring mental health disorders. Although many people have benefited from CBT in their recovery journey, few understand the science behind the therapeutic approach.

We sat down with Dr. Alia Kaneaiakala, the chief clinical officer of Phoenix Rising, an outpatient treatment center in Aliso Viejo, California, to understand the history of CBT and why it’s an important and popular option for people in recovery.


What is CBT?

Cognitive Behavioral Therapy, which combines behavioral and psycho- therapy, was one of the first evidence-based treatment methods for dealing with addiction, says Kaneaiakala, who uses tools from CBT to treat patients at Phoenix Rising. Because it has a long history and proven success, CBT is popular among therapists. CBT also is a natural fit for treating some of the issues that occur around addiction.

“CBT is based on the idea that thoughts influence feelings and actions,” Kaneaiakala explains. For many people struggling with substance abuse, negative thoughts often lead to harmful action, like using substances. CBT pushes people to challenge their beliefs, particularly those negative beliefs that aren’t rooted in reality.

“One of the biggest things CBT does is it challenges irrational beliefs,” Kaneaiakala says. “It challenges those types of thoughts that are borne out of fear or anxiety.”

This approach can work well when it is undertaken alongside a 12-step program, she adds.

“CBT is a good marriage to that. It works well.”


Deconstructing Core Beliefs

Most people come out of childhood with at least one negative core belief, Kaneaiakala says. You may believe that you are unlovable, or that you will never be able to achieve success. Subconsciously, people either spend their lives reinforcing their core beliefs — by, for example, finding romantic partners who don’t treat them well — or working hard to disprove them — perhaps by becoming a high-powered executive at any expense.

For people with substance use disorder, core beliefs can feed into negative thought patterns that lead to substance use. In order to sustain long-term recovery, people must be able to confront their negative core beliefs so that they don’t get pulled back into unhealthy thinking patterns months or years down the line.

“CBT is really useful for tackling negative core beliefs and looking for more rational ones,” Kaneaiakala says.

During therapy sessions, clients are taught to challenge their explanations or assumptions. For example, if someone cancels on you, you might jump to the conclusion that they don’t appreciate you, which would reinforce the negative core belief that you are unlovable. After CBT you might be able to look at the situation more rationally: perhaps your friend was sick or overwhelmed with work. You can see that the situation has extenuating circumstances that have nothing to do with you.

Implementing Changes In The Long-Term

One of the benefits of CBT is that people will see results relatively quickly and it may only take a handful of therapy sessions to work through each issue. That means that people can take on one issue during CBT and take time off to process that before committing to the next segment of therapy.

“They will do it in short-term sequences, working on one presenting problem,” Kaneaiakala says. “They use the interventions and methods to feel better, and then come back and work on a different problem next round.”

Another important aspect to long-term change through CBT is daily reinforcement. Much like the 12 steps need to be continuously implemented in your life, so do the changes that you bring about through therapy.

“CBT is based on practice, there is a lot of practicing by journaling and challenging behaviors,” Kaneaiakala says. “Doing that over time is another way of challenging old belief systems and implementing new ways of thinking.”


Phoenix Rising provides behavior health care services in southern California. Find out more at https://phoenixrisingbehavioral.com/ and follow them on Facebook and Twitter.

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