Cognitive Behavior Therapy, Addictions, & Legal Issues

Cognitive Behavioral Therapy (known as CBT) is a form of psychotherapy that focuses on how individuals think about themselves, the world and other people, and how the individuals’ actions will affect their thoughts and feelings.

CBT is beneficial to almost all individuals that are seeking psychotherapy. CBT is an approved treatment modality by most insurance companies, because when practiced correctly, it can be a short-term evidence approved modality. Without a large time investment, individuals can learn ways to identify their rational and irrational beliefs and can learn to see how their beliefs are affecting their thoughts and behaviors.

I have found CBT to be extremely helpful with two populations that I counsel. I specialize in dealing with patients who have some form of addiction (i.e., substances, gambling, sex, food, etc.) as well as working with males who are going through or have been through difficult marital/divorce/child custody cases.

In addressing addictions, we often talk about people needing to stop their addictions and work on developing ways to avoid relapsing. This is often easier said than done, but it is possible.

Here are some of the most important ways that CBT can help you:

  1. CBT focuses on the “here and now.” Not that your past experiences aren’t important to you; however, CBT focuses on what is affecting you today. CBT looks not at the people, places, and things, but rather individuals and what they are dealing with or not dealing with in the here and now. For the addict, yes, it is important to avoid places that could lead to a relapse; however, isn’t it more important to look at what they were feeling and thinking at the moment of their relapse?
  2. CBT, used early on in the treatment process of recovery, can significantly aid in educating an addict to what is really behind the cravings and urges, which are the thoughts and feelings. Almost every addict will talk about not wanting to feel or think a certain way. CBT allows us to teach them that those thoughts and feelings are always within them; however, they don’t have to react the same way to those thoughts and emotions. Changing their thoughts and emotions may aid patients in implementing the skills and tools needed to sustain long term recovery. Similarly, no matter what stage of the process patients are in with regards to a divorce, the common emotions that individuals will experience are guilt, grief, fear, anger, doubt, and regret, all very common and uncomfortable emotions for most individuals. As individuals go through divorce, it is not uncommon to hear thoughts such as: what the spouse is trying to do to the patient, how they are having parenting time taken away from them, how the spouse wants more money from them, how the patient is being unfairly treated in the court system, and the list goes on.
  3. The techniques of CBT can help individuals change their negative beliefs and to focus on being more optimistic. Clients can begin to experience a calmer and clearer view of their situation using CBT. In matters of divorce and child custody issues, people are often placed, whether due to their circumstances or the motives of another, into positions of vulnerability and extreme feelings of loss. When people are taught the skills and techniques of CBT, they then can redirect their energy to themselves and what it is they are afraid of handling (normally some emotion). As clients begin to express how they are feeling and what thoughts are going through their head, then they can start to say to themselves, “I am okay, this is an unpleasant situation, but I am okay and will be okay when this is over.” They learn to talk about the appropriate emotions they are experiencing and then, with the assistance of the therapist, look at why they were feeling this way and how to reframe their thoughts and actions.
  4. CBT can help individuals to address situations appropriately. CBT can aid in breaking the cycles of negative thinking, feelings and behavior. When individuals can identify the cycles clearly, they can change them, and then alter the way they are feeling.
  5. CBT’s can get individuals to where they can “do it themselves” and work out their way of addressing problems. CBT can help patients to break the awful cycles of negative thinking, sentiments, and conduct. When people see the parts of the endless loop plainly, they can transform that loop, and in this way change the way they feel.



About Gerald Opthof, Psy.D, LPC, LCADC

Dr. Opthof is a cognitive behavioral forensic psychotherapist who is licensed to practice in New Jersey. He is a member of the American Counseling Association. In his clinical experience, he has counseled individuals with addictive disorders such as alcohol, drugs, gambling, sexual, and computer addictions. Over the course of his career, he has been asked to appear on Caucus: New Jersey with Steve Adubato in regards to their Families in Crisis Series. He was appointed to serve as a member of the New Jersey Governor’s Council on Alcoholism and Drug Abuse and chaired their Prevention Sub-Committee.