Inall of these therapeutic approaches, the client and therapist typicallybegin therapy by conducting a thorough functional analysis of substanceabuse behavior (Carroll, 1998;Monti et al., 1994; Rotgers, 1996). This analysisattempts to identify the antecedents and consequences of substance abusebehavior, which serve as triggering and maintaining factors. Antecedents ofuse can come from emotional, social, cognitive, situational/environmental,and physiological domains (Miller and Mastria,1977). The functional analysis should also focus on thenumber, range, and effectiveness of the individual’s coping skills.
- Mood stabilizers (lithium), anticonvulsants (carbamazepine), clozaril, and serotonergic drugs are also under investigation.
- CBT combined with another evidence-based treatment such as Motivational Interviewing, Contingency Management, or pharmacotherapy is also efficacious compared to minimal and usual care control conditions, but no form of CBT consistently demonstrates efficacy compared to other empirically-supported modalities.
- However, a seminal review by Morgenstern and Longabaugh (2000) concluded there was very little support for improvement in coping skills as a unique mechanism in CBT for alcohol use disorder.
- Much of the focus involves the dopaminergic system, dynorphinergic kappa opioid receptors, and dynorphin.
- If aperson has low self-efficacy due to a lack of necessary coping skills, shemight be expected to have negative or distorted thoughts and beliefs aboutherself and her situation, have reduced motivation to even try to cope, andmay be depressed and perceive herself as helpless.
- A key element of CBT therapy is anticipating triggers and developing the self-control to cope with them.
TREATMENT APPROACHES
While reliance on the results of the functional analysis makes skillstraining particularly well suited for individual therapy, theseinterventions can easily be adapted for use in group settings (Monti et al., 1989). Similarly, theycan be used with inpatients or outpatients and can be administered as partof an intensive phase of treatment or as part of less intensive aftercare orcontinuing care. CBT is also compatible with a number of other elements intreatment and recovery, ranging from involvement in self-help groups topharmacotherapy (Carroll, 1998). Attributional processes and emotional responses also play a role in anindividual’s decision to use (Marlatt andGordon, 1985).
How Effective is CBT for Alcohol Addiction?
In a brief version of this therapy, there is less time to understand andrestructure all of the cognitions that may be influencing substance abuse.The therapist must use the early sessions to determine the most productivefocus of the therapy, given the short timeframe. If the client usedsubstances primarily to cope with negative mood states, then therapy mayfocus on understanding how the client’s interpretation of events led to thenegative moods. Behavioral therapies are often delivered using a specific manual, but theyare also adaptable to the individual client.
Duration of treatment
In a randomized controlled trial, 75 adults with marijuana use disorder were randomized to 2 sessions of brief treatment versus a 9-session clinician-delivered MET-CBT approach, or a 9-session version of TES emphasizing MET and CBT. Both MET/CBT conditions included a CM component in which participants could earn up to $435 in gift cards if all urines were negative for cannabis. Significantly more participants in clinician-delivered treatment (44.8%) and TES (46.7%) were abstinent at the end of treatment compared with the 2-session brief treatment (12.5%).
- As long as the clients remained substance free,they were able to remain in the work program and remain in the therapeutichousing; if they were found to be drinking or using drugs, they becameineligible for both the job training/work program and housing.
- Although it was initially developed as a therapy for depression, later CBT has been found to be useful for other mental health problems.
- If you are interested in learning more about cognitive behavioral therapy for substance use disorders, help is available.
- The research findings on the use of coping skills training with alcohol- andcocaine- dependent clients indicate that this strategy has strong empiricalsupport.
Cognitive-behavioral therapy (CBT) derives, in part, from both behavioral andcognitive theories. While sharing a number of procedures in common, CBT is alsodistinct in many ways from these other therapies (Carroll, 1998). In comparison to cognitive therapy, CBTplaces less emphasis on identifying, understanding, and changing underlyingbeliefs about the self and the self in relationship to substance abuse. Itfocuses instead on learning and practicing a variety of coping skills, only someof cbt interventions for substance abuse which are cognitive. A greater emphasis is also placed on using behavioralcoping strategies, especially early in therapy. While there appears to be considerable overlap in high-risk situations acrosssubstances (Cummings and Gordon,1980), there are also a number of substance-specific patterns.Emotional and situational risk factors have been examined among a clinicalsample of individuals who were primary abusers of alcohol, cocaine,marijuana, sedatives and tranquilizers, or heroin/opiates.
Clients who received the cueexposure as part of their standard outpatient treatment for cocaine use werealso less likely to drop out of treatment and had more cocaine-free weeksthan did clients attending the same outpatient program but who did notreceive cue exposure. The team at Oxford Treatment Center is available 24/7 to answer your questions about inpatient addiction treatment and outpatient drug and alcohol https://ecosoberhouse.com/ rehab in Mississippi. Our admissions navigators can help you explore different rehab payment options and verify your drug and alcohol rehab insurance coverage. Our writers and reviewers are experienced professionals in medicine, addiction treatment, and healthcare. AddictionResource fact-checks all the information before publishing and uses only credible and trusted sources when citing any medical data.
Everything You Need to Know About Cognitive Behavioral Therapy for Addiction
