The University of Arizona

Treatment Modalities and Treatment Settings for Illicit Drug Abuse
Psychosocial Treatment:
Cognitive Behavioral Therapies (CBTs)

Cognitive-behavioral therapies (CBT) target two processes thought to underlie substance abuse: 1) dysfunctional thoughts, such as the belief that controlling the use of substances is not possible, and 2) maladaptive behaviors, such as the practice of obtaining drugs.[1-4] Typical cognitive strategies include exploring the consequences of continued substance use to help foster the resolve to discontinue use, and recognizing and confronting thoughts about substance use. Behavioral strategies involve the functional analysis of the antecedents and consequences of substance use, and the development of strategies for dealing with cravings, emergencies, and relapse to use.

CBT generally includes social skills training, as the development of such skills is often hindered by substance use. Social skills training targets a person's capacity for 1) effective communication, 2) understanding the feelings of others to help facilitate social interactions, 3) improving nonverbal communication, 4) adapting to circumstances to maintain relationships, and 5) being assertive.[1,5] CBT also uses techniques to help patients develop greater self-control to avoid relapse. These can include identifying triggers for craving and use, developing coping strategies to deal with stressors associated with use, and understanding the decision chain that can lead to the re-initiation of use.[1,6,7]



  • (1) American Psychiatric Association. Practice Guideline for the Treatment of Patients with Substance Use Disorders. Arlington, VA: APA; 2007 Apr. Report No.: 164.
  • (2) Zweben JE. Review of clinical issues. In: Center for Substance Abuse Treatment. State Methadone Treatment Guidelines. Treatment Improvement Protocol (TIP) Series. Rockville: Center for Substance Abuse Treatment; 1993.
  • (3) CSAT. TIP 33: Treatment for Stimulant Use Disorders.Rockville, MD: SAMHSA; 1999.
  • (4) Carroll KM. A Cognitive Behavioral Approach: Treating Cocaine Addiction. Rockville, MD: NIDA; 1998. Report No.: 98-4308.
  • (5) Monti PM. Coping and Social Skills Training. In: Hester R, Miller W, editors. Handbook of Alcoholism Treatment Approaches: Effective Alternatives. 3 ed. Needham Heights: Allyn & Bacon; 2003. p. 213-36.
  • (6) Marlatt G, Witkiewitz K. Relapse Prevention for Alcohol and Drug Problems. In: Marlatt G, Gordon J, editors. Relapse Prevention: Maintenance Strategies in the Treatment of Addictive Behaviors. 2nd ed. New York: Guilford; 1985. p. 1-44.
  • (7) Annis HM. A Relapse Prevention Model for Treatment of Alcoholics. In: Miller W, Heather N, editors. Treating Addiction Behaviors: Process of Change.New York: Plenum; 1986. p. 407-33.