Cognitive Behavioral Therapy and Spirituality: A Winning Rx

Cognitive behavioral therapy (CBT) and spirituality are two approaches to recovery used by almost all rehab centers today and often in conjunction with traditional proven approaches like A.A. Cognitive behavioral therapy, which entails a restructuring of thoughts, is most often associated with therapists and therapy.  It focuses on the present and what to do about it, rather than dwelling on the root causes of one’s afflictions by delving into the past. Twelve-step programs, considered more spiritual in nature, are associated with 12-step meetings and counselors or even members themselves who have likely been in the trenches for an extended period of time. References to a higher power and God give 12-step programs their spiritual flavor, along with concepts like self-examination, surrender and acceptance. Successful treatment programs will include elements that are both cognitive and spiritual.

The Link Between CBT and AA

At first glance, it might seem that cognitive behavioral therapy and spirituality are exclusive of one another. However, many addiction experts point out that 12-step programs contain within them strands of CBT. The first of the 12 steps, for instance, asks the alcoholic or addict to consider current behavior – not the reasons for it – so that behavior modification can occur.  Another example is the fourth step, known as the personal inventory: filling in columns with incidents that trigger resentment or anger is a way to keep track of behaviors that need to change, and a way to create awareness of the way an alcoholic or addict responds. Yet another way 12-step programs address thinking is through the clichés often repeated among members: “I’m a drink away from a drunk,” “Listen to the message, not the messenger,” and “First things first” provide new ways to think about what happens in life. Repeated over time, they become part of the recovered individual’s new thought processes.

An emerging therapeutic approach known as “spiritually modified cognitive behavioral therapy” takes a person’s spiritual dimension into account when engaging him or her in therapy.  Like traditional CBT, spiritually modified cognitive behavioral therapy helps clients substitute more functional thinking for what 12-step programs refer to as “stinking thinking,” or thoughts that are self-defeating. Spiritual modification of CBT uses an individual’s religious, spiritual and worldview framework to foster recovery. Like 12-step programs, this approach combines the best of therapeutic worlds.

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