CBT belongs to a family of interventions that are focused on the identification and modification of dysfunctional cognitions in order to modify negative emotions and behaviours. CBT for substance use disorders includes several distinct interventions, either combined or used in isolation, many of which can be administered in both individual and group formats. Specific behavioral and cognitive-behavioral interventions administered to individuals are reviewed below, followed by a review of family-based treatments. The evaluation of CBT for SUDs in special populations such as those diagnosed with other Axis I disorders (i.e., dual diagnosis), pregnant women, and incarcerated individuals is beyond the scope of the current review, and thus the descriptions provided below focus on SUD treatment specifically. Despite the richness of its theoretical foundations, the literature thus far has not provided a clear picture of how CBT exerts its effects on AOD outcomes. The authors summarized the selection of potential mediators as related to self-efficacy, copings skills, craving/affect regulation/stress, and other (eg, social measures as well as more generalist constructs such as the therapeutic alliance).
- It skills training such as behavioural rehearsal, assertiveness training, communication skills to cope with social pressures and interpersonal problem solving to reduce impact of conflicts, arousal reduction strategies such as relaxation training to manage pain or anxiety as risk for relapse.
- Mindfulness based interventions or third wave therapies have shown promise in addressing specific aspects of addictive behaviours such as craving, negative affect, impulsivity, distress tolerance.
- CBT for AOD is a well-established intervention with demonstrated efficacy, effect sizes are in the small-to-moderate range, and there is potential for tailoring given the modular format of the intervention.
- Modern day CBT for addiction is decidedly integrative and increasingly so as the applications evolve to reach novel and understudied populations.
- The patient can learn to recognize the circumstances that trigger drinking or drug use, remove themselves from the situation, and use CBT techniques to alleviate the thoughts and feelings that lead to abuse.
Clinical Elements of CBT for SUDs
This state-of-the-science stands in contrast to a large evidence-base for efficacy across a range of possible implementation conditions (ie, stand-alone, combined with other interventions, delivered in a digital format). From the two review studies considered and the subsequent 15 studies of mediators of CBT effects, coping skills, self-efficacy, and reduced craving show promise, but there is minimal evidence to suggest cognitive behavioral therapy these processes are uniquely important to CBT and are more likely processes that are broadly relevant to AOD behavior change. In addition, technology offers strategies for enhancing our ability to study CBT and other interventions more systematically and more rigorously. In the sections below we elaborate on how these possibilities may accelerate development of cognitive behavioral interventions in the next 30 years.
- The exercises involve challenging negative thinking and developing positive coping skills for present and future use.
- During these sessions, a therapist focuses on helping the patient understand the connection between thoughts, emotions, and behaviors.
- These variables are essential in developing distress tolerance and reducing impulsivity, which are important variables in relapse process.
Treatment strategies in the relapse prevention
Modest relative efficacy in contrast to these conditions underscores how little we know about the specificity of CBT ingredients when delivered to populations with alcohol or other drug use disorders. A view of Supplemental Table 1 supports this point where non-specific contrasts were quite variable, but often involved addiction information, mutual support, and 12-step program involvement. These are established elements of community-based care and confer benefit in their own right (SAMHSA, 2017).
Cognitive Behavioral Therapy for Co-Occurring Disorders
Cognitive behavioural therapies are empirically supported interventions in the management of addictive behaviours. CBT comprises of heterogeneous treatment components that allow the therapist to use this approach across a variety of addictive behaviours, including behavioural addictions. Relapse prevention programmes addressing not just the addictive behaviour, but also factors that contribute to it, thereby decreasing the probability of relapse. Addictive behaviours are characterized by a high degree of co-morbidity and these may interfere with treatment response. Motivational Interviewing (MI) and motivational enhancement therapy (MET) are approaches that target motivation and decisional balance of the patient. Motivational interviewing (MI19,20) was developed in the context of behavioural trials for self-control for drinking and includes principles of expressing empathy, rolling with resistance and avoiding non- constructive arguments or conversations, supporting self-efficacy and developing discrepancy between desired life goals and substance use.
Cognitive Behavioral Interventions for Alcohol and Drug Use Disorders: Through the Stage Model and Back Again
Other efforts to increase access to CBT and other evidence-based treatments for SUDs are also underway.[75-77] Future research focusing on methods to bridge the gap between theory and practice in a way that supports community clinicians so that systemic change can truly be effective is of particular importance. As this paper has reviewed, many effective behavioral techniques for the treatment of substance use have been identified; however, use of such techniques is often scarce or non-existent in service provision settings. This meta-analysis provides an up-to-date summary https://ecosoberhouse.com/ of treatment efficacy in Cognitive Behavioral Therapy (CBT) for alcohol or other drug use disorders. CBT is effective for these conditions with outcomes roughly 15–26% better than average outcomes in untreated, or minimally treated, controls. CBT in contrast to minimal treatment showed a moderate and significant effect size that was consistent across outcome type and follow-up. When CBT was contrasted with a non-specific therapy or treatment as usual, treatment effect was statistically significant for consumption frequency and quantity at early, but not late, follow-up.
Disorders like anxiety and depression often cause negative thought patterns and behaviors. If your insurance doesn’t cover all of your therapy costs or if you don’t have insurance, there are other ways to pay. Some therapists also offer payment plans, scholarships, and sliding-scale fees based on income. Find answers here to frequently asked questions about CBT and how it can help people with a drug or alcohol use disorder overcome addiction for good. 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.
What is CBT and how does it work?
- You, nor your loved one, are under any obligation to commit to a Legacy Healing Center treatment program when calling the helpline.
- Specifically, any clinician mention of cognitions or thoughts about substance use was identified in 14 of the 379 sessions rated and mention of skills training was detected only 13 times (Santa Ana et al., 2008).
- Risa Kerslake is a registered nurse, freelance writer, and mom of two from the Midwest.
Because CBT focuses on identifying and replacing such thought patterns with more adaptive ones, it can help improve a person’s outlook and support skills that support long-term recovery. The first step in finding cognitive behavioral therapy near you might be to discuss your situation with your doctor so you can have an evaluation and ask for referrals to rehabs that offer CBT. Training in assertiveness involves two steps, a minimal effective response and escalation. When the minimal effective response (such as informing friends that “I do not drink”) is not sufficient to bring about change, the individual is instructed to escalate to a stronger response, such as warning, threat, involving others’ support. Role play, behavioural rehearsal and modeling are used to train patients in assertiveness.
Where Can I Receive CBT Treatment
