No one should assume the information provided on Addiction Resource as authoritative and should always defer to the advice and care provided by a medical doctor. CBT for substance abuse helps overcome alcoholism and drug addiction by dismissing false beliefs, developing mood-improving skills, and teaching the client effective communication. During cognitive behavioral therapy exercises, recovering addicts are taught to modify their feelings by changing their thoughts and behaviors. Cognitive behavioral therapy is scientifically proven to help treat a variety of conditions, including various mental health disorders and addictions. Cognitive behavioral therapy (CBT) is an evidence-based form of psychotherapy that can be effective for helping people overcome substance abuse and addiction.
Twelve-step facilitation therapy
While Ellis and Beck have similar views about the prominent role that cognitionsplay in the development and maintenance of substance abuse disorders, theirtheories differ in considering how the therapist should treat irrational ormaladaptive cognitions. Rational-emotive therapy is often more challenging andconfrontative, with the therapist informing the client of the irrationality ofcertain types of beliefs that all people are prone to. Beck, on the other hand,believes that the cognitive therapist, using a supportive Socratic method,should enlist the client in carefully examining the accuracy of her beliefs.Thus, Beck places more importance on the client’s https://ecosoberhouse.com/ own discovery of faulty andunproductive thinking, while Ellis believes that the client should simply betold that these exist and what they are. Nevertheless, there is substantialoverlap in both the theory and practice of these two therapies. Clearly,different clients will have different responses to these qualitatively differentapproaches to modifying their thoughts and beliefs. Before focusing more specifically on the cognitive-behavioral model, this chapterexamines the behavioral and cognitive theories and therapies that serve as thefoundations of and have contributed significantly to the cognitive-behavioralapproach to substance abuse treatment.
Is CBT Effective In Treating Addiction?
This represents the individual’s perception of asituation and an estimation of the potential level of stress, personalchallenge, or threat involved with the situation. Secondary appraisalrepresents the individual’s evaluation of her ability to meet the challengesand demands specific to the situation. This secondary appraisal, which willbe influenced by the extent, nature, and availability of the individual’scoping skills, further mediates the individual’s perception of stress andthe person’s emotional response. A goal of CRA is to make these alternative interpersonal and social sourcesof reinforcement available when the person is sober or drug-free, but tomake them unavailable if the person drinks or uses.
Relaxation techniques
Click on the state you are interested in, and you’ll get a list of the best centers in the area, along with their levels of care, working hours, and contact information. If one of Legacy’s treatment centers is not a good fit, a representative of Legacy may refer you to another detox or treatment center or the Substance Abuse and Mental Health Services Administration (SAMHSA) hotline to find a program that best suits your needs. You, nor your loved one, are under any obligation to commit to a Legacy Healing Center treatment program when calling the helpline. “You have to challenge your beliefs about what is a healthier strategy with your money, for your family, for yourself,” she adds. Using the ABC model, Hornstein explains that the A in the activating event might be buying the lottery tickets because you (B) believe it’s going to make you wealthy. “You haven’t been able to get control over the compulsive behavior of going and buying a lot of lottery tickets.
Cognitive Behavioral Therapy (CBT) for Addiction
- Nevertheless, review of taped TAU sessions by independent raters blind to treatment assignment indicated CBT techniques and strategies were among the most infrequently used in practice.
- Behavioral couples therapy (BCT), or behavioral marital therapy, is a behavioral treatment for both alcohol and drug use disorders that has been in development since 1985 [39].
- Residential rehabilitation programs (sometimes called therapeutic communities) are usually long-term programs where people live and work in a community of other substance users, ex-users and professional staff.
- Contingency management (CM) is a treatment approach that involves systematically reinforcing abstinence, usually with tangible goods or money in exchange for drug-free urine toxicology or treatment compliance.
CBT for substance abuse equips an individual to overcome addiction by revealing the emotions and actions that lead to it. Unwelcome feelings and behaviors are usually a consequence of a person’s environment or past experiences. Through CBT techniques, recovering addicts realize that unwanted thoughts, feelings, and actions are irrational. The exercises help the addict in understanding why they experience certain feelings or behave in a particular way. CBT has some things in common with rational emotive behavioral therapy, which was developed on its basis.
The authors acknowledge that other treatments, including inpatient or residential programs, prevention programs, and self-help programs such as Alcoholics Anonymous (AA) do have some evidence for effectiveness. Again, because many of these approaches have not been tested widely using the criteria below, a discussion of the merit and evidence for these and other approaches is beyond the possible scope of this article. Furthermore, the authors’ approach will not address therapies and EBPs for acute withdrawal symptoms; rather the authors will focus on treatments for adult substance users [19]. Treatment research scientists may develop, implement, and test interventions for groups of patients with similar complaints, symptoms, and histories. These efforts can be guided by rigorous scientific and experimental methods to enhance the validity of inferences about the intervention, and to assist members of the research, academic, and clinical policy communities to determine if the intervention merits further support. This kind of evidence, by virtue of the use of rigorous empirical standards, is arguably less subjectively biased and more objective and systematic in its acquisition.
Behavioral couples therapy
By addressing these underlying psychological disorders, cognitive-behavioral treatment exercises treat the underlying reasons for addiction and recognize signs of relapse in the future. The literature provides a somewhat complex narrative on the efficacy of combined CBT and pharmacotherapy. In the largest trial to date, the added benefit of the combination was not observed, but review data suggest some benefit, and particularly for adding pharmacotherapy to CBT for alcohol use disorder.
- SE has been found to be an effective intervention for opiate use disorders, especially when delivered by skilled therapists [90] and in controlled settings such as methadone maintenance.
- Simpson et al [101,102] have documented the importance of duration of treatment, derived empirically at 90 days or more on average, in association with positive outcomes.
- Negative consequences expectedfrom cocaine include global negative effects, anxiety, depression, andparanoia (Jaffe and Kilbey, 1994;Schafer and Brown, 1991).
- If a slip occurs, the therapist shouldtry to bring the more negative attributions for relapse (internal, stable,and generalized) to the client’s attention so that he can identify thesetendencies and learn how to change them.
What Is An Example Of Cognitive Behavioral Therapy?
- In June 2020, 13 percent of people in the United States either started using substances or increased their use as a way to cope with the COVID-19 pandemic.
- The manual-guided version was evaluated in comparison with MET and CBT in Project MATCH NIAAA Project MA TCH Study and produced favorable outcomes on abstinence, treatment retention, and other life dimensions [79].
- To the extent that the individual is lacking in the coping skills necessaryto deal with the demands of high-risk substance abuse or relapse situations,his sense of self-efficacy decreases.
- To our knowledge, this is the first targeted meta-analysis of CBT in combination with pharmacotherapy for adults with AUD and other SUDs to summarize the data in a manner relevant to clinical practice guidelines.
According to behavioral theory, changes in behavior come about through learningnew behaviors. Because substance abuse behavior is learned, it can be changed byteaching the client more adaptive, alternative behaviors aimed at achieving thesame rewards. Figure 4-3provides anoverview of some of the advantages of behavioral theories of substance abuse anddependence and their treatment. CBT uses a variety of coping skills to help you recognize and restructure unhealthy thought and behavioral patterns.5,13 During your initial assessment for alcohol use disorder, your therapist will help you to identify underlying triggers and unhealthy coping skills that are connected to your alcohol use.
Patients who complete residential programs achieve better outcomes on drug misuse, crime, employment and other social functioning measures.[36,37] It is unclear whether this relates to choice or motivation on the part of the service user or whether active retention in treatment achieves successful outcomes. To conclude, the use of therapeutic communities for treatment of substance use disorders does not have a strong evidence base. A number of published treatment manuals are available to guide skillstraining with substance users (Carroll,1998; Kadden et al.,1992; Monti et al., 1989).These manuals provide a session-by-session overview of the intervention. The skills to be taught are either specific to substanceabuse (e.g., coping with craving, refusing an offer of alcohol or drugs) orapply to more general interpersonal and emotional areas (e.g., communicationskills, coping with anger or depression). Some might be viewed as essential and would beexpected to be used for all clients, while others would be viewed as moreelective in nature and would be selected for a particular individual basedon the functional analysis. The ability to individually tailor the skillstraining to the client’s needs represents one of the strengths of CBT.
Cognitive restructuring
- Therapists who practice CBT with patients who have addiction issues may use a variety of techniques both within sessions, as well as tasks to be completed outside of sessions.
- In addition to consideration of traditional CM rewards—monetary prizes, vouchers for goods, or treatment “privileges” (e.g., take-home doses of methadone)—the arrangement of social contingencies, such as is evident in BCT approaches, should be considered.
- Data on mechanisms of action, however, are quite limited and this is despite preliminary evidence that shows that CBT effect sizes on mechanistic outcomes (ie, secondary measures of psychosocial adjustment) are moderate and typically larger than those for AOD use.
- Cognitive behavioral therapy did not perform better than another evidence-based modality (eg, motivational enhancement therapy, contingency management) in this context or as an add-on to combined usual care and pharmacotherapy.
- The Figure summarizes study inclusion for the present report on combined CBT and pharmacological interventions for adult AUD/SUD (PRISMA diagram).
McCrady also included behavioral self-control training as another promisingbut underutilized treatment approach (McCrady, 1991). Hester indicated that there is good empiricalsupport for behavioral self-control training in achieving the goal ofmoderate, nonproblematic drinking (Hester, 1995). In randomized clinical trials, problem cbt interventions for substance abuse drinkersassigned to behavioral self-control with a goal of either moderation orabstinence typically have comparable long-term outcomes. Although behavioralself-control approaches have been used primarily with alcohol problems, theyhave also been used with other substances such as opiates (van Bilsen and Whitehead, 1994).
