Cognitive Behavioral Therapy in Adolescent Substance Use & Mental Health Treatment

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Cognitive Behavioral Therapy, more commonly referred to as CBT, is an evidence-based, psychological treatment modality that is used for the treatment of various mental health and substance use disorders. CBT is a form of talk therapy, and it is known as the gold standard for treating both mental health and substance use disorders. (1) 

At Guardian Recovery, we use a range of evidence-based therapies, providing a program of clinical care that is both comprehensive and highly individualized. Our teen addiction CBT program can help you, or your teen, develop adaptive coping techniques and engage in cognitive restructuring. Contact us today to learn more about our teen rehab CBT program, and to start your personal journey of recovery.

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What Is Cognitive Behavioral Therapy (CBT)?

CBT is a psychotherapeutic intervention that helps clients identify and change self-destructive patterns of thinking. Many teens who experience mental health and substance use disorders have automatic negative thoughts, which often contribute to worsening symptoms and their inability to achieve or maintain recovery for an extended period of time. There are a wide range of proven strategies employed as part of CBT. These strategies are all geared towards helping teens identify negative patterns of thinking, challenge and change these thoughts, and replace them with more productive and objective ideas. 

CBT is based on the following core principles: (2) 

  • Psychological, and substance use disorders, are based on maladaptive or unhelpful ways of thinking.
  • Psychological, and substance use disorders, are based on learned patterns and behaviors. 
  • Those experiencing mental health, or substance use disorders, can develop more effective ways of coping, resulting in a reduction in their symptoms. 

The Effectiveness of CBT in a Substance Use Disorder (SUD) Treatment Program 

There has been extensive research regarding the effectiveness of different evidence-based therapies. Research has found CBT to be effective in the treatment of substance use disorders. (3) The National Institute on Drug Abuse suggests that the skills clients learn while participating in CBT remain with them long after clinical treatment has concluded. (4) Research has also found that individuals receiving CBT treatment had higher response rates when compared to other treatment modalities. (5) 

The Benefits of Cognitive Behavioral Therapy for Adolescent Substance Use Treatment

Adolescents enrolled in CBT treatment learn a wide variety of tools and skills. These tools can  serve as beneficial components of CBT therapy. 

Benefits of utilizing CBT during the treatment of mental health and substance use disorders for adolescents include: (6) 

  • Gaining the ability to identify and change maladaptive personal beliefs and detrimental beliefs about themselves, or their substance use, (for example, beliefs like, “I am only hurting myself.” Or, “I can control my drinking or drug use.”)
  • Learning the ability to adequately assess high-risk situations, and consistently choose to spend time with people or seek out environments that are more conducive to recovery. 
  • Changing the automatic thoughts that lead to negative thinking patterns, and replacing them with healthy, adaptive, and productive ways of thinking. 
  • Developing an increased ability to work through the psychological urges, triggers, and drug cravings that would otherwise lead to relapse. 
  • Changing negative, ritualistic behaviors associated with substance use and mental health disorders. . 
  • Changing psychological beliefs and reactions to poor mental health, or relapse that can easily lead to the continuation of a vicious cycle. 
  • Developing a personal arsenal of appropriate responses that can be utilized by teens when they are offered a drink, another chemical substance, or asked to engage in risky behaviors. 
  • Learning how to “play the tape through” or appropriately weigh the pros and cons of a return to substance use or a maladaptive behavioral pattern. 
  • Developing a healthy sense of self-respect, and learning how to consistently improve self-esteem through esteemable acts. 
  • Learning how to rely on support groups and positive support systems.

To learn more about the extensive benefits of CBT, or to learn more about the comprehensive level of therapeutic care we provide in each of our adolescent clinical treatment programs, reach out today.

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Addressing Behaviors & Triggers Related to Substance Use

CBT for adolescents allows them the opportunity to be able to identify and address any behaviors or triggers that may be contributing to their mental health or substance use concerns. During CBT, the therapist will ask the client to describe any triggers or negative thoughts, feelings, and behaviors related to their substance use. (7) 

What Kinds of Behaviors Are Addressed During CBT?

A wide range of behaviors are addressed during CBT. These can include maladaptive behaviors that may be influencing any mental health or substance use disorders. 

According to the American Psychiatric Association, CBT can be used to help treat behaviors related the following mental health disorders: (8) 

  • Depressive disorders.
  • Anxiety and panic disorders.
  • Eating disorders.
  • Sleep-related disorders. 
  • Post-traumatic stress disorder (PTSD).
  • Psychotic disorders.
  • Personality disorders.
  • Substance use disorders. 

What to Expect During CBT Sessions?

At Guardian Recovery, we believe in client-driven therapy, meaning that specific therapeutic goals are determined by the collaboration of each individual client and their licensed therapist. 

The topics that are covered during CBT differ significantly based on the unique needs of each client. The topics we tend to focus on include:

  • Personal history. 
  • Negative thoughts, feelings, and behaviors. 
  • Substance use history, if relevant to the individual.  
  • Family history of mental health and substance use. 
  • What it was like growing up, and the potential presence of any underlying or unresolved childhood trauma.
  • Personal wellness and recovery goals.
  • Other important life goals, such as entering into a long-term career, returning to school and meeting personal educational goals, entering into a healthy and committed relationship, or overcoming long-standing challenges,
  • How to effectively overcome personal triggers and work through uncomfortable feelings and emotions.
  • The grieving process – how to grieve loss in a healthy and effective way.
  • Coping techniques to utilize when experiencing stress, and anxiety/stress management techniques.
  • Communication techniques.
  • Emotional regulation techniques. 

Though many underlying issues are resolved while the client is enrolled in treatment, we encourage a continuation of individual therapy once treatment has concluded.

Integrating CBT With Other Evidence-Based Therapies for Treatment of Teens

CBT can be combined with other therapeutic modalities, such as Motivational Interviewing, DBT, or EMDR. Research has also found that those receiving DBT treatment were more likely to achieve full remission when compared to other treatment options. (9) Additionally, EMDR has been found to be effective in reducing PTSD symptoms in those with co-occurring substance use disorders. (10)  CBT can also be utilized during individual, family, and group therapy. Integrating CBT with other therapies ensures that each client is receiving comprehensive and  individualized care. 

Frequently Asked Questions

Below is a curated list of frequently asked questions regarding CBT in adolescent substance use and mental health treatment. 

Is CBT Effective for Both Substance Use & Mental Health Issues?

Yes, CBT has been found to be effective in treating both substance use and mental health disorders. (11) 

What Should Parents Expect During Their Child’s CBT Sessions?

Parents should expect for their child to be able process their thoughts, feelings, and behaviors in a safe environment, with the guidance of a licensed mental health professional. 

Can CBT Help Prevent Relapses in Teens?

Yes, CBT relapse prevention helps prevent the occurrence of initial lapses after a commitment to abstinence, and to prevent any lapses that occur from becoming a full relapse. (12)

How Can Parents Reinforce CBT at Home After Treatment?

Parents can reinforce CBT techniques at home by being open to adapting the principles learned during session into their family’s daily routines. 

What Behaviors, Feelings, & Thoughts Are Remedied During CBT?

Any negative or maladaptive thoughts, feelings, and behaviors are addressed and remedied during CBT treatment. 

Can Parents Be Involved in Their Child’s CBT Sessions?

Your child’s therapist will keep you informed every step of the way during your child’s treatment. If parents want to address any familial issues, our family therapy program is the best place to do so.  

How Long Will the Benefits of CBT Therapy Last?

The National Institute on Drug Abuse suggests that the skills clients learn while participating in CBT remain with them long after clinical treatment has concluded. (13) 

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If you, or your teen, are experiencing mental health or substance use concerns, CBT treatment may be beneficial. At Guardian Recovery, we can provide you with a complimentary, initial psychological evaluation to determine the presence of any mental health or substance use disorders. Our teen therapy program can help your teen achieve evidence-based skills to help meet their specific treatment goals. One of our Treatment Advisors is ready to speak with you, and your family, to help guide you all through our simple admissions process. Ask about our free, no obligation, insurance benefits check to determine which of our treatment options is covered by your health insurance plan. Start your recovery and wellness journey today at Guardian Recovery.


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Disclaimer: Does not guarantee specific treatment outcomes, as individual results may vary. Our services are not a substitute for professional medical advice or diagnosis; please consult a qualified healthcare provider for such matters.


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Reviewed professionally for accuracy by:

Ryan Soave


Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

Written by:

Cayla Clark

Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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