In order to understand why cognitive behavioural therapy could be considered a treatment for substance abuse, it is necessary to understand that substance abuse can be viewed as a learned behaviour and therefore the obvious way to treat someone who has learned this type of behaviour is to teach the substance abuser to accept responsibility for their behaviour and new behaviour patterns. Cognitive and behavioural change methods are derived form social learning theory and can be used not only to treat substance abuse but many varying types of obsessive/compulsive behaviours( Bandura, 1977, Ellis, 1987, Beck 1989).

Keene ( 1997 ) uses the analogy of a driver in explaining the stages of substance abuse. This analogy simplifies the stages of abuse thus

Type of drug user type of driver intervention
Experimental, unsafe learner Prevention, education
Recreational, safer weekend driver Safety regulations
Risky, Unsafe Racing driver make as safe as possible
Dependent, compulsive Car Fanatic Abstinence or control
Has underlying problems Escapist Alternative solutions

Initially like the learner driver the experimental drug user will be unaware of the actual hazards of their new experience, the amount that can be safely taken etc, the new driver will enjoy the driving experience as he/she gets better at it, just as the drug experimenter will become better at recognising the amount of drug required to give them the feeling they wish to experience as they continue to use for recreational purposes. At this point the input of a driving instructor is used to educate the learner driver about how to drive while minimising risks. The drug user will probably learn about risk minimisation from others who abuse drugs and at this stage intervention in the form of education may be enough to aid risk minimisation or to alter the behaviour before it becomes habitual. The recreational user can progress into more risky drug taking habits in order to find the ‘feeling’ they want just as a driver may progress to racing, or joy riding in order to get more thrills, at this stage in either a driving or drug taking career it is important that safety issues of drug taking or dangerous driving are addressed. Once this stage is over a culture of dependency can arise and then the behaviour is almost habitual, the method of using a drug, the rolling of a joint like the stealing of a car becomes a compulsion and here it is important that some method of control is placed over the behaviour of the individual. For some it is more than a compulsion it is a form of escapism and for these people alternative forms of therapy must be examined such as regression, the underlying cause of this type of behaviour needs to be addressed before the behaviour of the addiction is treated.

Beck (1993) defines cognitive behavioural therapy as ‘ the application of the cognitive model of a particular disorder with the use of a variety of techniques designed to modify the dysfunctional beliefs and faulty information processing characteristic of each disorder’.
This approach refers to the education of the individual about the risks and benefits of changing their behavioural patterns. (Williams and Keene 1995) believe that education alone is not enough to promote healthy behaviour patterns.

Botvin (1990), Davies and Coggans (1991), Dorn and Murji (1992) and Williams and Keene (1995) all identify that the following combination of methods and approaches are desirable to treat the behaviour of the substance abuser.
Transfer of Knowledge or cognitive methods. The life and social skills approach, social and community approaches, a mixture of knowledge and skills, with back up in the family and the community, furthermore Dorn and Murji state the aims of these methods as being providing information to individual decision makers, seeking to remedy supposed deficits in moral values or living skills, bolstering peer resistance strategies in the context of anti-drug norms. Providing alternatives to drug misuse through youth and community participation.

Jessor Collins & Jessor (1972) found that at school age and in teenage yrs the credibility of peers is greater than that of an adult therefore it is the credibility of the teacher or educator that is of importance at this stage of education in drug prevention.

Sanchez-Craig, (1990) this cognitive behavioural technique is based on the theory that dependent drinkers can control their drinking, clients are capable of self- control and of taking responsibility for their treatment. This style of treatment enables the drug worker to lead the client to a stage whereby they are able to face up to their behaviour patterns and make decisions on how to modify that behaviour until they (the client) is in control.

Raistrick and Davidson (1985) the application of psychological techniques to alcoholism and drug dependence.
S. McGonigal (2005)