CBT vs. MI: Therapy for Addiction & Substance Use Disorder

Key Takeaways

• Cognitive Behavioral Therapy (CBT) and Motivational Interviewing (MI) are both proven to help people recover from addiction.

• CBT helps change negative thoughts and behaviors that lead to drug or alcohol use.

• MI helps build a person’s motivation to change by exploring personal reasons for recovery.

• These therapies can be used on their own or together for stronger results.

• Choosing the right therapy depends on a person’s needs, goals, and stage of recovery.

Introduction

Therapy plays a big role in helping people overcome addiction and substance use disorders. It’s more than just talking—it’s about learning new ways to think, feel, and act.

Two of the most helpful types of therapy are Cognitive Behavioral Therapy (CBT) and Motivational Interviewing (MI). These approaches are evidence-based, which means scientists have studied them and found they work. They’re used all over the country in recovery centers, including here at Virtue Recovery Las Vegas.

Let’s look at what each one is, how they’re different, and how they help people get better.

What Is CBT (Cognitive Behavioral Therapy)?

CBT is a kind of therapy that helps you notice and change unhelpful thoughts and behaviors. Sometimes, people get stuck in patterns of thinking that lead to poor decisions—like using drugs or alcohol to cope with stress, sadness, or anger.

CBT teaches people how to:

• Recognize triggers

• Replace negative thoughts with healthier ones

• Practice new skills to avoid relapse

• Set goals and track progress

CBT often includes homework and worksheets between sessions. It’s structured, with clear goals. This makes it great for people who want practical tools to stay on track.

It’s also helpful for people with co-occurring mental health issues like depression or anxiety, which are common in recovery.

What Is MI (Motivational Interviewing)?

Motivational Interviewing is a different kind of therapy. It’s more about having a conversation than doing exercises or lessons.

In MI, the therapist helps the person:

• Talk about their goals and values

• Explore their reasons for change

• Work through any doubts or fears about quitting drugs or alcohol

MI is especially helpful for people who are unsure if they’re ready to stop using. Instead of pushing someone to change, MI supports their decision-making and helps build confidence in their ability to recover.

It uses techniques like:

• Open-ended questions

• Affirmations

• Reflective listening

• Summarizing (often called OARS)

This approach is non-judgmental and builds trust between the person and the therapist.

Key Differences Between CBT and MI

Here’s how these two therapies compare:

Both therapies are effective, but they serve different purposes depending on where a person is in their recovery journey.

Evidence Supporting CBT and MI in Addiction Treatment

Many studies show that both CBT and MI work well for treating substance use disorders.

In fact, researchers have done hundreds of randomized controlled trials (the gold standard in science) to study these therapies. According to the Journal of Substance Abuse Treatment, both CBT and MI have been linked to:

• Lower relapse rates

• Less drug or alcohol use

• Better treatment outcomes

Both individual and group therapy formats have shown success. They’re often used in treatment programs across the U.S. and are backed by the National Institute on Drug Abuse (NIDA) and Substance Abuse and Mental Health Services Administration (SAMHSA).

Can CBT and MI Be Combined?

Yes, and they often are!

Therapists can combine CBT and MI to get the best of both. This is especially helpful for people who:

• Aren’t sure if they want to quit (MI helps with motivation)

• Need tools to stay sober once they’re ready (CBT helps with skills)

This combo is also good for people with co-occurring mental health disorders, like PTSD, depression, or anxiety.

Here’s how it might look:

1. Use MI at the start of treatment to help someone open up and explore their goals.

2. Once they feel more motivated, use CBT to teach strategies to avoid relapse and deal with stress.

This flexible approach helps people get what they need at every step of their recovery.

Visual Aid: CBT vs MI in Addiction Treatment

This infographic gives a quick side-by-side comparison of CBT and MI. It highlights differences in focus, therapist role, structure, goals, and techniques. It’s a great way to see how each method works and why both are useful tools in recovery.

Choosing the Right Therapy for Recovery

There’s no “one-size-fits-all” answer when it comes to addiction treatment.

Some people might do best with CBT alone, while others need MI first to build their motivation. Many benefit from using both together.

Here’s what can help guide the choice:

• Where you are in your recovery (new to it or already in treatment)

• Your comfort level with structure

• If you’re feeling motivated or still unsure

• Mental health needs (like anxiety or depression)

At Virtue Recovery Las Vegas, therapists work closely with clients to create a treatment plan that’s just right for them. Our team is trained in both CBT and MI and can adapt the approach to fit your needs.

Conclusion

Both Cognitive Behavioral Therapy (CBT) and Motivational Interviewing (MI) are powerful, evidence-based tools to help people overcome addiction and live healthier lives. CBT helps you change your thinking and habits. MI helps you find your own reasons to change.

Used alone or together, these therapies support lasting recovery.

If you or a loved one needs help with addiction or substance use, we’re here to guide you every step of the way.

Call Virtue Recovery Las Vegas today at 866-520-2861 and take the first step toward healing.

FAQs About Comparing Cognitive Behavior Therapy and Motivational Interviewing

What is the difference between cognitive-behavioral therapy (CBT) and motivational interviewing (MI) in the context of addiction treatment?

Cognitive-behavioral therapy focuses on identifying and changing negative thought patterns and behaviors associated with substance use, while motivational interviewing is a therapeutic approach that helps clients explore and resolve ambivalence towards behavioral change. Both are effective treatments used in addiction treatment.

How does group therapy integrate CBT and MI for substance use disorder?

Group therapy can effectively integrate CBT and MI by utilizing the structured approach of cognitive-behavioral therapy to help participants understand their behaviors, while motivational interviewing enhances motivation and engagement among group members, fostering a supportive environment for change.

Can cognitive-behavioral therapy be effective for individuals with co-occurring disorders?

Yes, cognitive-behavioral therapy is often used in addiction treatment for individuals with co-occurring disorders. It helps clients address both their substance use and mental health challenges by integrating therapeutic techniques that target behaviors and thought processes related to both issues.

How do therapy sessions differ in focus between CBT and MI?

Therapy sessions focused on cognitive-behavioral therapy primarily work on cognitive restructuring and behavioral change, while sessions involving motivational interviewing aim to enhance motivation and resolve ambivalence towards treatment. Both methods can be combined for more effective outcomes.

What is the role of motivational enhancement in the treatment of substance use?

Motivational enhancement plays a crucial role in treatment by fostering a client’s intrinsic motivation to change. It helps individuals articulate their reasons for wanting to overcome substance use and supports them in setting achievable goals during therapy sessions.

Are there specific outcome measures used to evaluate the effectiveness of CBT and MI in addiction therapy?

Yes, various outcome measures are used to evaluate the effectiveness of CBT and MI, including reductions in substance use frequency, improvements in mental health, and overall quality of life. Systematic reviews and meta-analyses often assess these therapies’ impact on treatment success.

How can integrating CBT and MI improve treatment for substance use disorders?

Integrating CBT and MI can improve treatment by combining the structured problem-solving approach of cognitive-behavioral therapy with the client-centered, motivational techniques of motivational interviewing. This combination addresses both the psychological and motivational aspects of recovery.

What is a treatment group, and how does it differ from a control group in addiction research?

A treatment group consists of participants who receive the therapeutic interventions, such as CBT or MI, while a control group may receive no treatment or an alternative intervention. Comparing outcomes between these groups helps researchers evaluate the effectiveness of the therapies used in addiction treatment.

What are some key components of motivational interviewing and cognitive-behavioral therapy?

Key components of motivational interviewing include expressing empathy, developing discrepancy, rolling with resistance, and supporting self-efficacy. In contrast, cognitive-behavioral therapy focuses on cognitive restructuring, behavioral strategies, and skills training to help individuals manage their substance use.

Resources

https://pmc.ncbi.nlm.nih.gov/articles/PMC2882846/

https://www.researchgate.net/publication/338873233_Differences_and_similarities_between_MI_and_CBT

https://www.sciencedirect.com/science/article/abs/pii/S0272735817304087

Gigi Price LMSW, LCDC Clinical Director

Gigi Price holds licenses as a Master Social Worker and Clinical Drug Counselor. She completed her master's degree in Social Work at Texas State University. Over the last decade, Gigi has been dedicated to utilizing evidence-based practices to enhance patient care and treatment planning, resulting in positive, long-term outcomes for patients and their families. Her passion lies in creating a treatment environment where professionals collaborate to bring about positive change and provide a safe, trustworthy therapeutic experience. Patients can be confident in receiving top-quality care under her leadership. In her role as the Clinical Director of Virtue Recovery Houston, Gigi conducted research to identify the most effective approaches for treating patients with acute mental health diagnoses, PTSD, and Substance Use Disorder. She then assembled a team of skilled clinicians who could offer various therapeutic modalities, such as Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), Acceptance and Commitment Therapy (ACT), Somatic Exposure, Eye Movement Desensitization and Reprocessing (EMDR), and Cognitive Processing Therapy (CPT). Gigi takes pride in overseeing the development and implementation of Virtue Houston's Treatment Program, which includes two specialized therapeutic curricula tailored to the unique needs of individuals struggling with mental health issues, addiction, and PTSD.

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