Harnessing the Power of CBT for Effective Relapse Prevention

Cognitive Behavioral Therapy (CBT) is a form of psychotherapy that focuses on changing patterns of thinking or behaviors that can lead to problems in your life. CBT is a highly effective evidence-based practice used to treat a range of mental health problems, including anxiety, depression, and addiction.

If you’re struggling to stay sober, CBT might be able to help you change the behaviors and thought patterns that contributed to your drug or alcohol use in the past. In fact, it’s been shown to reduce relapse rates for people who struggle with alcohol and drug addiction by up to 60% when compared to “traditional” treatment methods, such as the 12 Steps of Alcoholics Anonymous.

Most people who have a problem with substance use struggle with one or more cognitive distortions, which are problematic ways of thinking.

All-or-nothing thinking is a perfect example. This is when you look at everything in black and white terms, ignoring gradations and in-between situations. This cognitive distortion can directly lead to or worsen relapse.

For example, after leaving rehab, you find yourself craving alcohol. You go into a bar, order a beer, and take a drink.

Then you think to yourself, “Well, it’s too late–I’ve already relapsed, so there’s no point in walking away now. I might as well drink as much as I can.”

Many people in this situation could have walked away after that initial drink. Staying and drinking to excess is not required, but the cognitive distortion pushes you to do something you wouldn’t normally do.

CBT is all about harnessing the power of your brain to change your behavior and experiences. It operates on the premise that your thoughts, feelings, and actions are interconnected and that, by changing one, you can change the others.

This is done through various techniques and exercises practiced in your daily life.

What makes CBT particularly powerful is its practicality and accessibility. Unlike some other forms of therapy, CBT is typically short-term, goal-oriented, and focused on the present.

It can be adapted to suit a range of needs and circumstances and can be practiced independently or with the guidance of a therapist. Many people only need to work with a therapist for a little while to put together a plan and start practicing it regularly. It is then possible for them to continue on their own.

This approach can be immensely helpful when leaving rehab, detox, a sober house, or an IOP/PHP (intensive outpatient/partial hospitalization) program. By putting these practices into place while still in treatment, you can more effectively prevent relapse once you leave.

Understanding Relapse: Causes and Triggers

In simple terms, relapse is returning to a former state or condition, particularly in the context of addiction or mental health issues. It’s a common part of the recovery process, but it can be highly challenging and disheartening when it happens.

There are many potential causes and triggers for relapse, and they’re often unique to each individual. However, there are some common triggers, including:

Stress
Negative emotions (anger, fear, guilt, shame)
Physical discomfort
Conflict or confrontation with others
Social pressure from people who are still drinking or using
Exposure to your substance of choice or the context in which it was used

Understanding your triggers is crucial in preventing relapse as it allows you to recognize and avoid potentially risky situations. This knowledge can also give you a target for your CBT work.

Once you understand your triggers, you and your therapist can come up with a game plan specifically designed to help you when those specific situations arise.

It’s also worth noting that relapse isn’t always a sudden event. It often occurs gradually, going through three stages:

Emotional relapse (when you’re not thinking about using, but your behavior is setting you up for potential relapse)
Mental relapse (when you’re wrestling with the idea of using)
Physical relapse (when you actually use again)

Recognizing these stages can be incredibly helpful in preventing a full relapse.

The Role of CBT in Relapse Prevention

Cognitive behavioral therapy is a powerful tool in preventing relapse because it addresses the causes, triggers, and underlying thought patterns and behaviors that contribute to it.

By learning to understand and change your thinking and behavior, CBT can help you avoid relapse and stay on track with your recovery. It can also help you reduce the impact of a relapse once it starts and even reverse course.

One advantage of CBT for relapse prevention is its focus on self-efficacy. Self-efficacy is our belief in our ability to accomplish tasks and reach goals.

Cognitive behavioral therapy can improve your self-efficacy, strengthening your ability to resist the urge to use substances and helping you cope with life’s challenges and stresses without resorting to old habits.

For example, you might believe you have no choice but to continue having relationships with toxic friends who encourage you to use or drink. You might feel trapped in these relationships, feeling there is nothing you can do and no way out.

A therapist trained in CBT might suggest strategies to help you understand you have power in this situation. You can say no to friends who want to hang out if you know they’re drinking or using, or you can tell them you won’t be able to spend time with them until they decide to get sober.

Having a clear idea of actions you can take is only part of the solution. You probably already know what you need to do–you just struggle to do it.

Your therapist might help you dig into the reasons why you won’t tell a friend who’s using no, allowing you to understand the faulty thinking that underlies this belief, challenge it, and formulate strategies to deal with the thinking that would keep you from setting a clear boundary with this person.

For example, it may become apparent during therapy that you have low self-esteem and often think cruel or mean thoughts toward yourself. As a result, you may actively spend time around people who will treat you poorly and lead you to relapse.

Your therapist might prompt you to identify and question the beliefs contributing to your low self-esteem. Whenever you notice having a negative thought about yourself, you can challenge it with an undeniable positive fact about yourself. Over time, this will help you break the habit of self-criticism, leading to a boost in self-esteem.

This process can give you the courage you need to set boundaries with toxic friends, removing major triggers from your life.

Another key aspect of CBT for relapse prevention is its focus on coping skills. These are strategies and techniques you can use to deal with difficult situations and emotions. Through practicing these skills, you can better manage your triggers and avoid relapse.

For example, you may find that you’re heavily inclined to use substances when you’re angry, especially if you get angry about something at work. Your therapist can help you develop coping skills, helping you get into the practice of calling someone when you’re angry, meditating, or doing deep breathing exercises.

Once you get into the habit of coping with your anger in a healthy way, you will be less likely to use substances after a frustrating day at work, preventing relapse.

When combined with traditional methods of recovery, such as the 12 Steps or SMART Recovery, you’ll have a much better chance of preventing a relapse and staying sober long-term.

Embracing CBT for Successful Relapse Prevention

Cognitive Behavioral Therapy is a powerful tool for relapse prevention. By helping you understand and change your thinking and behavior, CBT can empower you to avoid relapse and stay on track with your recovery.

While it can be challenging at times, with patience, practice, and perseverance, you can harness the power of CBT for your recovery journey.

If you or someone you know experiences mental health issues, it is important to seek help from a qualified professional. Our Resource Specialists can help you find expert mental health resources to recover in your community. Contact us now for more information on this free service to our users.

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About the Author: Cristal Clark, LPC-S, is the Medical Reviewer for ASIC Recovery Services. She reviews all website content for quality and medical accuracy. She is a master’s level Licensed Professional Counselor Supervisor and graduated from Liberty University in 2011. She has worked in the behavioral and mental health field for over 12 years and has a passion for helping others. She has been Clinical Director and CEO of a 200-plus-bed facility, PHP, and IOP, with experience managing a team of counselors, individual/group/and family therapy, and coordinating continuum of care. Cristal is trained in EMDR and certified in non-violent intervention. She is a member of American Counseling Association and American Association of Christian Counselors.

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If you’re going through treatment, have developed a relapse prevention plan, and are thinking about getting into a sober living or IOP program to augment your recovery, we can help.

At ASIC Recovery, our Intensive Outpatient Program (IOP) and Partial Hospitalization Program (PHP) are dedicated to helping you develop healthier coping skills and build a supportive recovery network so that you can achieve long-term sobriety.

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