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What Is Cognitive Behavioral Therapy?

by Cedric Dent

September 26, 2022
An aboriginal woman receives cognitive behavioral therapy (CBT) from an Asian-American clinician in a cozy office.

Cognitive behavioral therapy is one of several psychotherapy modalities geared toward treating mental health conditions. It’s commonly applied to people experiencing substance use disorder. Also called talk therapy, cognitive behavioral therapy (CBT) is the fundamental, skills-based, evidence-based method of getting those in addiction treatment to exercise routine ways of  thinking through their problems. The American Psychological Association defines it as “a form of psychological treatment” that “usually involves efforts to change thinking patterns” and “behavioral patterns.”

Not All Talk Therapy Is Cognitive Behavioral Therapy

There are several forms of talk therapy that can be applied for a variety of reasons. They aren’t created equal, though, at least not when it comes to treating a drug or alcohol addiction. CBT sometimes gets called talk therapy simply because it’s included in a broad category of modalities. Nevertheless, there are several ways in which CBT differs from other generalized talk therapy treatments. 

Typically, the term “talk therapy” treatment can refer to anything that involves discussing one’s feelings. Most commonly, in fact, a practitioner will solicit a description of the past week or a person’s most recent life developments. You’ll talk about the latest happenings, and the discussion is more or less aimless. CBT is a goal-oriented method focused on getting to the root of a specific problem in a limited amount of time.

CBT takes a set number of sessions, each running for the same amount of time, to identify areas of life most related to the problem and make those areas less problematic. Landmark Recovery uses this recovery tool in its treatment efforts for patients who enroll in Landmark’s program. Michelle Dubey, chief clinical officer at Landmark Recovery, explained the differences between a well-known subset of CBT called dialectical behavior therapy. With dialectical behavior, there’s more emphasis on changing behavioral patterns. 

Four Steps of CBT

Technically, there are four basic steps to applying CBT, though application of all four isn’t as simple as going through each in order.A mulatto woman in a rose-pink blouse receives cognitive behavioral therapy (CBT) from an indigenous therapist..

  1. List the client’s unproductive thoughts, and separately list their potential replacement thoughts. Write out the unproductive thoughts in full, but be just as detailed about the replacement thoughts you write down. 
  2. Take note of every problematic area in the client’s life.
  3. Review these lists with the client in the contexts of various problematic areas of life.
  4. Coach the client on how to take note of those problematic areas, notice the unproductive thoughts they have at those times and swap them out for the replacement thoughts discussed already in session.

In theory, CBT should aim to install replacement thoughts into the minds of clients. This is a key component that can be achieved in any of a variety of ways. For instance, a practitioner might have you write equal and opposite statements to your negative thoughts. They might prompt you with the question, “If this negative statement weren’t true, what would the truth be?” Therapists sometimes focus on what these unproductive thoughts overlook to draw your attention toward the fuller picture.

It’s imperative that you be made to regularly dwell on these lists you’ve made, too. You have to become exceptionally aware of the binary opposition your own thoughts have toward the productive thoughts you’re supposed to have. That’s what’ll teach you how you consistently set yourself up for failure in your own mind over and over. The whole point is to show you your self-destructive pattern and set you up to defeat it.

What Cognitive Behavioral Therapy Is For

CBT is ideally used to treat alcohol use disorder, anxiety and depression, sleep disorders, panic disorders, phobias, post traumatic stress disorder and substance use disorder. It’s essentially a roadmap to having a more positive mindset but not privileging generally positive thoughts. It’s about replacing specifically the destructive thoughts with whatever’s going to keep you from succumbing to your vices.

The aforementioned dialectical behavior treatment is a version of CBT that accomplishes this in an even more specific way. It focuses CBT’s methods on mindfulness, interpersonal effectiveness, distress tolerance and emotion regulation. The general tenor of this variant is impulse control. 

All of this remains pretty abstract if you’re not actually working with a licensed professional. If you or someone you know is ready to address a substance use disorder, go to Landmark Recovery or call a recovery specialist at 888.448.0302.

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