The cognitive model of addiction is distinguished from other approaches to addiction then, because it moves away from the emotional, biological or social causes for the disease. This isn’t to say the cognitive model of addiction ignores these factors, but just that it doesn’t focus primarily on influences other than the patient’s own beliefs. Cognition is a mental process. It relates to perception, judgment and reasoning.
What does the cognitive model of addiction mean in practice? For therapists it means finding out what core beliefs (conscious or unconscious) are allowing the addiction behavior to emerge. Importantly then, therapists have to interview and assess patients as individuals. There can be no one-size-fits-all.
The cognitive model of addiction was popularized in 2005 with the publication of “Beau's Cognitive Model of Addiction” which formally, looks like this: [(Stress + False Beliefs) x Rumination] + Distraction = Addiction
In plainer terms, patients feel stress and believe the addictive behavior is a good solution, they think about it and, when they are able to ignore the consequences, they perform the toxic behavior. Treatment is directed at exposing the false beliefs at the root of the problem. Cognitive therapy is combined in addiction treatment most often with behavioral therapy. The combination attacks the false beliefs while teaching skills to deal with stress in a healthier manner.
Criticisms of the cognitive model of addiction come from the inability to really pin down where the mental errors come from. For instance, it cannot explain the physical changes seen on fMRI that come with addiction. The feedback and cravings are more than just mental events – we can see altered brain chemistry. It also cannot explain the apparent influence of genetics.
However, because cognitive based therapies have a well respected track record in general psychology for many other problems (notably depression) some form of it is used in almost any type of addiction therapy. Even in the non-medical realm, like AA or NA, you will find references to “Stinkin’ Thinkin’” – a nod to cognitive processes that are harmful.