If your preferred coping method for stress comes in a packet of 25, you might be hesitant to stop smoking — after all, how else will you handle high pressure situations? Throw in other self-defeating thoughts — “The damage is done, so why should I stop smoking now?” — and you have plenty of reasons that might keep you from quitting.
But what if you could learn other ways to handle stress? Hint: You can — and that’s where cognitive behavior therapy (CBT) comes in.
How CBT Works
CBT is a psychotherapy technique that focuses on identifying negative thoughts and developing new ways of thinking about situations, according to the Association for Behavioral and Cognitive Therapies (ABCT). It combines two approaches: cognitive and behavior therapies.
Participating in cognitive behavior therapy means working with a specially-trained therapist to talk about what’s on your mind and learn ways of coping with feelings. Some people work individually with a therapist, while others work in group sessions. The focus is on the challenges you're facing in your life today and their solutions — in your case, how to quit smoking — and not on what has happened to you in the past, according to the ABCT.
Your CBT therapist will help you identify distorted and negative thought patterns and recognize and change inaccurate beliefs. Participants learn how to deal with stress and avoid unhealthy thoughts and behaviors. You're usually given "assignments" to do in between sessions as a way of practicing what you're learning.
CBT isn't just for smoking cessation. It can also help people deal with a number of emotional health and behavior issues, the ABCT notes, including:
- Mood disorders
- Eating disorders
- Substance abuse
CBT is a goal-directed and problem-focused form of therapy, with participants focused on learning rational thinking and self-counseling skills. You and your therapist will work together to determine when you have successfully completed the goals of your therapy.
CBT for Smoking Cessation
Using CBT to help you quit smoking can:
- Increase your confidence in your ability to quit smoking
- Help you explore any ambivalence about quitting
- Identify your smoking triggers and help you find ways to avoid them or respond differently
- Teach you ways to cope with stress and the urge to smoke
You’ll be taught to be on the alert for such negative thoughts like, "I'll never be able to quit smoking," or "What's the use of quitting now?" Plus, your therapist will work with you to develop responses to these thoughts and have you practice them so they become almost automatic.
The goal is to change your thought patterns so that new, healthy patterns replace older, destructive ones. You’ll also learn to distinguish between realistic and unrealistic thoughts and to practice skills aimed at changing thought and behavior patterns.
CBT may be used in conjunction with other strategies, such as medication, exercise, and rewards.
Need another reason to consider CBT? Research published in 2016 in the journal Substance Abuse: Research and Treatment examined 92 published articles about smoking cessation strategies and found that CBT was consistently effective in helping people quit smoking. The therapy also doesn’t carry the side effects of certain medication-based treatments, the researchers reported.
Finding a Therapist for CBT
You can find a qualified therapist in a number of ways. For instance, ABCT has a database of therapists who are certified in cognitive therapy. You can also contact the psychology department at a local university or medical center and ask if they have a clinic or a referral service. In addition, your doctor, community mental health center, mental health specialist, hospital psychiatry department, or social service agency may also be able to refer you to a qualified therapist in your area.
Be sure to ask the therapist about his or her training and treatment approach. Determine how many sessions will be needed and how frequent they will be. Ask, too, about the fee schedule as the costs can vary. Some therapists and clinics have a sliding fee scale; others have set fees. Check with your employer and your insurance carrier to see whether a portion or all of the costs will be covered.
Pros and Cons of CBT
Like any treatment, CBT comes with advantages and disadvantages. Do your homework in advance: Learn as much as you can about CBT before your first session, including which therapists you want to see, how much you want to pay, and more.
The pros of using CBT can include confidence-boosting skills and a greater insight into your life — plus, of course, the ability to quit smoking, according to the ABCT.
But the major drawback to CBT is the cost, especially if you need more therapy sessions that aren’t covered by your insurance. It may also be difficult to find a therapist trained in cognitive behavior therapy, particularly if you don't live in a major metropolitan area.
—Additional reporting by Madeline Vann, MPH