Cognitive Behavioral Therapy for Addiction Treatment

Cognitive Behavioral Therapy for addiction treatment

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Cognitive behavioral therapy (CBT) is an umbrella term for a set of scientifically-proven psychological treatments that are effective for a number of mental health disorders. It was developed more than half a century ago by American psychiatrist, Dr. Aaron T. Beck, and is commonly used to treat diverse conditions, such as anxiety, phobias, personality disorders, schizophrenia, marital discord, and substance abuse.

Psychotherapists (psychiatrists, psychologists, and social workers) use cognitive behavioural therapy to teach patients specific skills that are useful in overcoming addiction. CBT is widely available as part of inpatient, outpatient, individual, and group therapy programs. It is a low-risk treatment that is flexible and has a good reputation for being effective in substance abuse recovery.

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Table of Contents:

What is CBT Therapy?

Nurse with behavioral therapy

Cognitive-behavioral therapy (CBT) is a type of short-term psychotherapy usually conducted over 6-20 sessions. During these sessions, the therapist focuses on helping the patient understand the connection between thoughts, emotions, and behaviors. The goal of cognitive behaviour therapy is to help people deal with problematic thoughts and feelings to overcome mental health issues such as addiction. CBT therapists intervene at different stages in the thought-emotion-behavior cycle to help recovering addicts develop the skills to choose positive thoughts and behaviors.

What is cognitive behavioral therapy? It is a research-based, result-oriented, hands-on treatment that takes a practical problem-solving approach to changing thinking patterns and behaviors in recovering addicts. Although it was originally developed as a therapy for depression, CBT has been found to be useful for a number of other mental health problems, including:

  • Post-traumatic stress disorder (PTSD)
  • Anxiety
  • Psychosis
  • Attention deficit disorder
  • Bipolar disorder
  • Eating disorders
  • Obsessive-compulsive disorder
  • Addiction

Many people with substance abuse problems benefit from cognitive behavior treatment. In fact, CBT is widely used during addiction recovery. An increased awareness of thoughts, emotions, and actions as well as their consequences leads to a better understanding of the connections between the three. This helps the addict in understanding the motivations that led to the substance abuse in the first place.

A key component of cognitive behavioral therapy exercises for addiction is understanding how thoughts, emotions, and behaviors influence each other. For example, thoughts and behaviors have an impact on a person’s emotions. On the other hand, feelings or emotions influence a person’s thoughts and behaviors. During CBT exercises, recovering addicts are taught to modify their feelings by changing their thoughts and behaviors. The goal is to overcome addiction by acquiring control over unwanted emotions and thoughts.

Many people are surprised to learn that there is a link between anxiety and drug abuse. Cognitive behavioral therapy addresses a number of coexisting mental health problems that frequently accompany substance abuse. By addressing these underlying psychological issues, CBT exercises treat the underlying reasons for addiction and prevent relapses in the future.

How Does Cognitive Behavioral Therapy Work?cbt-therapy

Unwelcome feelings and behaviors are usually a consequence of a person’s environment or past experiences. Through CBT, recovering addicts come to realize that undesirable thoughts, feelings, and actions are illogical and irrational. The exercises help the addict in understanding why they experience certain feelings or behave in a particular way. CBT equips an individual to overcome addiction by revealing the emotions and actions that lead to substance abuse.

Many addicts automatically think negative thoughts. These thoughts are impulsive and based on feelings of fear, self-doubt, and misconceptions. Addicts often try to mask these painful feelings with alcohol or recreational drug use, which over time lead to addiction. CBT exercises involve revisiting painful emotions and learning positive behaviors to replace the substance abuse as a coping mechanism.

Therapists help recovering addicts focus and reexamine destructive thought patterns. These flawed perceptions change the way an individual looks at the present and the future. CBT addresses five common cognitive distortions that affect addiction recovery:

  • Dwelling only on negative emotions
  • Disqualifying positives thoughts as inconsequential
  • Generalizing negative events as never ending
  • Perceiving a situation as absolutely black or white
  • Assuming certain thoughts and beliefs are true without evidence

During cognitive-behavior therapy, clients learn interventions to reduce stress, control negative behaviors, and improve general well-being.

How Can Addicts Benefit from Cognitive Behavioral Treatment?

CBT is frequently used during addiction treatment because its efficacy has been proven over the years. During cognitive behavior therapy exercises, the therapist and the addict work together, relying on the therapist’s expertise and the addict’s understanding of himself or herself. During the sessions, clients discover that they have the power to choose positive thoughts and behaviors.

Cognitive-behavioural therapy is a short-term treatment that involves active participation by the patient, both during sessions and at home. The skills taught during the sessions need to be practiced during homework assignments and daily life. The treatment addresses current problems and takes a step-wise approach to achieving the goals. Throughout the course of treatment, the therapist tracks the addict’s progress and develops further goals.

Very often, automatic negative thoughts are the underlying cause of addiction disorders. CBT helps overcome alcoholism and drug addiction by dismissing false beliefs, developing mood-improving skills, and teaching the client effective communication. Cognitive therapy examples include:

  • Learning to distinguish between emotions and thoughts
  • Becoming aware of how thoughts can sometimes negatively influence emotions
  • Noticing automatic thoughts and their effect on emotions
  • Critically evaluating automatic thoughts – are they accurate or biased or assumptions?
  • Developing the skills to identify, interrupt, and replace negative thoughts with positive ones

Triggers or cravings prevent many addicts from getting clean and remaining sober. According to the National Institute on Drug Abuse, cognitive-behavior therapy helps recovering addicts identify and correct destructive behavioral patterns. A key element of CBT is anticipating triggers and developing the self-control to cope with them. The patient learns to recognize the circumstances that trigger drinking or drug use, remove themselves from the triggering situation, and use CBT exercises to alleviate the thoughts and feelings that lead to abuse.

Behavioral Therapy Techniques

There are some specific CBT examples that are effective in addiction recovery. Some cognitive behavioral therapy techniques used by therapists are discussed below:

  • Keep a record of negative thoughts and look for objective evidence to disprove these automatic thoughts. The goal is to develop more balanced thinking and critically evaluate thought patterns.
  • Replace negative thoughts with positive ones and observe the effect on behavior. The goal is to discover what works for the individual in terms of self-criticism or self-approval.
  • Recall a memory that brings up strong negative emotions. The goal is to revisit the painful memories, and over a period of time, reduce the anxiety they cause.
  • Perform pleasant activities that are fun and healthy and can be easily incorporated into the daily routine. The goal is to reduce automatic negative thoughts and the need to drink or use drugs to suppress these painful feelings.

Typical cognitive-behavioral therapy sessions last 45 minutes. The therapist serves both as a teacher and a teammate and discusses the client’s stressors, irrational thoughts, and negative emotions. The exercises involve challenging negative thinking and developing positive coping skills for present and future use. Techniques include relaxation exercises, learning to be more assertive, improving insight, modifying thinking patterns, and monitoring and correcting negative behaviors.

Cognitive-Behavior Therapy versus Other Therapies

Cognitive behavioral therapy examples differ from other psychotherapies in a number of key ways. CBT does not try to get to the bottom of a person’s subconscious to determine their actions or behavior. CBT does not take a patient-centered approach where the therapist passively listens, allowing the patient to independently resolve the issues. In other words, a recovering addict will do more than just talk and the therapist will do more than simply listen during a cognitive-behavioural session.

woman lying on the sofa

The fundamental principle of cognitive behavior therapy is to address harmful thought patterns and implemen more positive ways of thinking. This helps regulate distressing feelings and control destructive behavior. The therapist and client work in collaboration to seek alternate thought patterns. This type of therapy can be conducted in both individual and group sessions, making it very flexible, unlike some other psychotherapies. The practical skills and coping strategies learned during these sessions can be applied to everyday life.

Cognitive-behavior therapy is a more hands-on approach compared to other less engaging psychotherapy techniques which may take years to have a meaningful impact. CBT is a goal-oriented, problem-focused, actionable, adaptable treatment. This short-term treatment often produces measurable results in less than 20 sessions. For this reason, CBT is included in many addiction rehabilitation programs to give recovering addicts the immediate coping strategies they need.

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View Sources
  1. https://etd.ohiolink.edu/rws_etd/document/get/osu1133779846/inline

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  • art marr
    NEW CBT procedure for management of addiction Presented here is a novel cognitive-behavioral procedure that significantly increases opioid and dopamine levels in the brain and accompanying positive affect. The procedure represents a simple variation of mindfulness protocols and is easy to employ and falsify. Please note that this procedure is meant for a practitioner or therapist. The neuro-science is cited as a means of justifying the procedure. But the ultimate proof is in the pudding, or in the effectiveness of the procedure itself. My work is largely based on the latest iteration of incentive or discrepancy-based models of motivation representative of the work of Dr. Kent Berridge of the University of Michigan. Berridge is a renowned bio-behaviorist and affective neuroscientist and was kind to vet and endorse the little book I have linked below. My explanation and argument are tiered into three parts, for a lay audience (pp.7-52), an expanded academic version (pp.53-86), and a formal journal article published on the topic in the International Journal of Stress Management. The procedure is a variant of mindfulness practice but entails a new definition of mindfulness based on contemporary neurologically grounded models of learning. A brief summary of my argument In discrepancy models of motivation (or bio-behaviorism), affect is schedule dependent. VR (variable-ratio) schedules of reinforcement or reward (gaming, gambling, creative behavior) are characterized by moment to moment positive act-outcome discrepancy, which parallels the release of the neuro-modulator dopamine that is felt a state of attentive arousal, but not pleasure. However, heightened pleasurable affect as well as heightened attentive arousal is also reported while performing under VR schedules, but only when the musculature is in a state of inactivity or relaxation. Relaxation induces the activity of mid-brain opioid systems and is felt as pleasure. Because dopamine and opioid systems can co-activate each other, concurrent contingencies which induce relaxation (mindfulness protocols) and attentive arousal (purposive or meaningful behavior) will result in a significant spike in affective tone as both dopaminergic and opioid activity will be much higher due to their synergistic effects. The result is the ability to be mindful and relaxed almost constantly, and to significantly increase felt levels of ‘pleasure’ and ‘energy’. The procedure to do this, outlined on pp. 47-52, has several important characteristics. Behavior Analytic- no appeal to events outside of objective behavior. Simple – explained in five minutes, and refutable as quickly. Cognitive Behavioral – coheres to CBT principles, and is structured, brief, and rational. Also, as a layman (though academically trained in behavioral psychology, I am an executive for a tech company in New Orleans), I am most curious to see if this procedure is effective. Formal test is not at first necessary, but informal exposure is since the procedure is simple and innocuous and its predictions significant and clear.