CBT and 12 Steps in Addiction Treatment

One of the most common ways of treating mood disorders, such as anxiety and depression, is Cognitive Behavioral Therapy (CBT); and one of the most common ways of treating addiction is following the Twelve Steps program espoused by Alcoholics Anonymous.

Mental health and addiction

Mood disorders often accompany drug or alcohol addiction, and this phenomenon results in their treatment plans aligning. CBT and the Twelve Step program work in similar ways – having individuals identify their problems, helping them come up with ways to control and alter their dysfunctional thoughts, and enabling them to maintain this positive change. CBT helps patients modify their dysfunctional thoughts and behaviors to make them more positive, and the Twelve Steps guide addicts through letting go of their ego, accepting help and changing their habits (which include but are not limited to drug and alcohol abuse).

12 Steps and CBT

Steps 1, 2 and 3 of the Twelve Steps deal with admitting a problem and asking for help. An alcohol or drug addict begins the Twelve Steps by surrendering to a ‘Higher Power’. Similarly, a patient being treated through CBT shares control with a therapist. Both processes involve patients developing insight and admitting that something is wrong – that they are not healthy and need an external force to help restore them to health. A key difference, however, is that CBT involves helping patients strengthen their control of their own lives, while the Twelve Steps involve individuals handing over control to an entity stronger than themselves.

An addict reflects on his or her personality in Step 4 by making an “inventory.” This is very similar to the process of a CBT patient listing down their dysfunctional personality traits and the thoughts they have to change. CBT involves a lot of writing and list making, wherein patients try and keep a record of their changes in thoughts and attitudes. Patients write their own personal goals as a part of CBT; and even though the Twelve Steps guide patients to a common objective, drug addicts and alcoholics are free to interpret them in any way and make their own positive goals as well.

Through CBT, people with mood disorders build open communication channels with their therapists, as well as their families and other important people in their life. Addicts in the Twelve Step program are taught to communicate with their Higher Power. Steps 5 through 7 involve addicts admitting their problems to, and asking Higher Power for, help in removing their core defects. Patients going through CBT will also ask their therapist to help them remove their defective thoughts.

Steps 8 and 9 have to do with asking for forgiveness and making amends. A patient undergoing CBT will be encouraged to do the same to avoid held back by negative emotions such as guilt and self-loathing. Understanding that they have hurt people will aid the paradigm shift of a CBT person’s thinking. If they have hurt someone, their clearer and less dysfunctional thoughts will recognize this; making amends validates the fact that they are seeing things in a new light. Both addicts and people with mood disorders ask for forgiveness so that they can move forward with their positive new behaviors.

Much like the idea of keeping a “personal inventory” in Step Ten, therapists help persons undergoing CBT keep records of how they feel and act – for the rest of their lives. Addicts who have been discharged from a rehab center need to constantly think about how they are living their life and how they can avoid falling into the traps of their old habits or thoughts. Steps 11 and 12 call for drug and alcohol addicts to maintain their contact with a Higher Power and help others. The Twelve Step program and CBT follow the principle that recovery is a lifelong process that comes with hard work and dedication.

Hope Trust rehab incorporates CBT, 12 Steps and other therapeutic tools to provide an integrated and holistic approach to addiction treatment.