How CBT works: The thought–feeling–behavior cycle 

CBT is based on the idea that perceptions shape emotions and actions. For example: 

• Thought: “I can’t handle stress without using drugs.” 
• Feeling: Anxiety, hopelessness. 
• Behavior: Returning to substance use. 

Therapists use CBT to teach people to identify and challenge these negative thoughts, replace them with healthier beliefs, and practice new behaviors. Over time, CBT can help break the cycle of addiction and emotional distress. 

Key principles of CBT 

Several principles make CBT especially effective for people in addiction treatment: 

• Structured and time-limited: Usually effective within 12–20 sessions, and sets clear goals for the future. 
• Goal-oriented: Focused on solving specific problems like cravings, relapse triggers, or depression. 
• Skills-based: Clients learn practical tools they can use for life. 
• Collaborative: Therapists and clients work as a team to identify patterns and make changes. 

Cognitive-behavioral therapists can also take a strengths-based approach. A strengths-based approach helps you identify positive qualities about yourself—your goals, beliefs, talents, morals—so you can use them to become resilient. 

CBT vs. Traditional talk therapy 

Unlike traditional talk therapy, which often explores the past, CBT emphasizes the present and the future. Instead of just talking about problems, CBT provides concrete strategies to cope with cravings, manage emotions, and rebuild a meaningful life in sobriety. 

CBT is a type of talk therapy, but it's more goal-oriented than other forms of talk therapy (psychotherapy). Rather than client-led sessions, CBT will be guided by expert therapists. They'll be able to help you identify feelings and emotions so you can recognize them on your own. They will also work with you to figure out what kind of behaviors you need to change to reach your goals in recovery.  

Core CBT techniques and skills 

During treatment, clients practice useful skills such as: 

• Cognitive restructuring: Identifying and reframing distorted thoughts. 
• Behavioral activation: Scheduling rewarding, healthy activities to boost mood. 
• Exposure therapy: Safely facing fears and reducing avoidance. 
• Problem-solving and coping skills: Developing strategies for everyday challenges. 
• Mindfulness and emotional regulation: Staying present and reducing reactivity. 
• Homework and progress tracking: Practicing skills outside sessions to build long-term habits. 

Is CBT effective? Research evidence and limitations 

CBT is one of the most researched therapies in the world, and is recommended as a front-line therapy for treating substance use disorder (SUD). That's because it's effective in: 

• Managing cravings: Learn practical strategies—like noticing triggers, riding out urges, and finding new ways to cope—so cravings feel less overwhelming. 
• Changing unhelpful thoughts: Catch and challenge thoughts like “just one won’t hurt” or “I can’t handle stress without using.” Replacing them with healthier beliefs makes it easier to stay on track. 
• Building new habits: Discover activities and routines that bring you joy, purpose, and structure—without substances. 
• Boosting confidence: Each time you practice these skills successfully, you gain confidence that you can handle tough moments without using. 
• Preventing relapse: By planning ahead for high-risk situations, you’re ready with strategies before the urge even hits. 

CBT isn’t a perfect fit for everyone. People with very complex trauma or severe personality disorders may need longer-term or specialized approaches. Still, for most individuals in recovery, CBT is a powerful and adaptable tool. 

What conditions does CBT treat? 

At Sheridan Grove Recovery, we use CBT to address both substance use disorders and co-occurring mental health conditions: 

Our licensed professionals provide specialized mental health support. We know that most people with addiction also have co-occurring mental health issues, and we're here to provide integrated support. CBT may be a cornerstone of your personalized therapy plan when you start our program.  

Online CBT and teletherapy 

For those who can’t always attend in person, online CBT and teletherapy options are available nationwide. These can include live video sessions with licensed therapists or guided digital CBT programs for independent practice. 

We do not offer virtual therapy options at Sheridan Grove Recovery. However, we can help you find the right type of care when you're completing our program. We can help you determine if in-person or telehealth programs are the right fit for your journey. Our team can also recommend which types of therapy can help you keep making strides in recovery. 

CBT vs. Other evidence-based therapies 

CBT shares similarities with other talk therapies. In fact, many modern talk therapies are specific types of CBT. Here's how cognitive-behavioral therapy stacks up against the other therapies we offer at Sheridan Grove: 

• ACT: Emphasizes acceptance and values-based living rather than changing thoughts.  
• DBT: Focuses on mindfulness, emotion regulation, and interpersonal effectiveness to help manage intense emotions.  
• Life skills training: Teaches practical skills to improve daily functioning and decision-making.  
• Motivational enhancement therapy (MET): Aims to strengthen motivation and build commitment to change.  
• Motivational interviewing (MI): A collaborative approach to help individuals identify and resolve ambivalence toward change.  
• Person-centered therapy: Focuses on empathy, unconditional positive regard, and empowering individuals to find their own solutions.  
• Rational emotive behavior therapy (REBT): Targets and disputes irrational beliefs to promote healthier thinking and behavior. 

CBT, in contrast, mostly focuses on recognizing and changing thought patterns. It's highly effective when paired with other therapy methods, like those listed above, and with medication.