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Chapter 4 Brief Cognitive-Behavioral Therapy Brief Interventions and Brief Therapies for Substance Abuse NCBI Bookshelf

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. CBT can give you the tools and a way to apply newly formed skills to make changes and feel successful, according to Hornstein. See Table 2 for a list and description of the studies reviewed in the following subsections.

Also assisting patients in setting smaller goals in the service of longer term goals is an important exercise. The therapist practicing CBT will also challenge the attributional process
and emotional aftermath of a relapse. If a slip occurs, the therapist should
try to bring the more negative attributions for relapse (internal, stable,
and generalized) to the client’s attention so that he can identify these
tendencies and learn how to change them. Clients can be helped to see the
relapse as caused by a lack of appropriate coping skills for the particular
situation (i.e., external), alterable with training or practice (i.e.,
unstable), and not implying that everything the person does is wrong (i.e.,
specific). This change in perspective will help reduce the client’s sense of
helplessness and loss of control.

Efficacy of MBIs Compared With Usual Smoking Interventions

These findings suggest that
treatment not only should rectify deficiencies in coping abilities, but
that it may be necessary to focus on skills to deal with both general
stress and substance-related temptation. Furthermore, it may be
necessary to develop coping skills specific to several possible
situations in which the client may use substances. In substance use-related situations, coping “refers to
what an individual does or thinks in a relapse crisis situation so as to
handle the risk for renewed substance use” (Moser and Annis, 1996, p. 1101). Cognitive-behavioral theory posits that substance users are deficient in
their ability to cope with interpersonal, social, emotional, and
personal problems.

  • Clients
    involved in the abstinence-contingent program had fewer cocaine-positive
    urine samples, fewer days of drinking, fewer days of homelessness, and more
    days of employment during the followup period than those in the standard
  • In other words, the approach is well-articulated, but despite this, knowledge on MOBC (ie, how it works) and specific matching factors (ie, for whom it works) is limited.
  • The large evidence base from Stage II randomized clinical trials indicates a modest effect size with evidence of relatively durable effects, but limited diffusion in clinical practice, as is the case for most empirically validated approaches for mental health and addictive disorders.
  • Cognitive restructuring techniques are employed to modifying beliefs related to perceived self-efficacy and substance related outcome expectancies (“such as drinking makes me more assertive”, “there is no point in trying to be abstinent I can’t do it”).
  • However, reporting of therapist training (44%), supervision frequency and/or methods (70%), and fidelity (7%) was variable in the sample of studies.

Although CBT for substance abuse is characterized by heterogeneous treatment elements—such as operant learning strategies, cognitive and motivational elements, and skills building interventions—across protocols several core elements emerge that focus on overcoming the powerfully reinforcing effects of psychoactive substances. The neurobiological basis of mindfulness in substance use and craving have also been described in recent literature40. 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. Cognitive reframing of lapses, coping imagery for craving and life style interventions, such as physical activity are used to help develop skills to deal with craving and broaden the patient’s behavioural repertoire.

CBT Sessions Explained

Because cognitive behavioral therapy is a structured, goal-oriented educational process focused on immediate problems, the process is usually short term. Although other forms of therapy can be long term and are not time limited, CBT is usually completed in 12 to 16 sessions with the therapist. This meta-analysis provides an up-to-date summary of treatment efficacy in Cognitive Behavioral Therapy (CBT) for alcohol or other drug use disorders.

Neither addictionresource.com nor AAC receives any commission or other fee that is dependent upon which treatment provider a visitor may ultimately choose. CBT for substance abuse equips an individual to overcome addiction by revealing the emotions and actions that lead to it. Although it was initially developed as a therapy for depression, later CBT has been found to be useful for other mental health problems.

The Cognitive-Behavioral Approach to Substance

Since then, cognitive behavioral approaches have been among the most-studied treatment approaches for addictive behaviors, with much of that literature published in Psychology of Addictive Behaviors. Two advantages of CBT are that it is relatively brief in duration and quite
flexible in implementation. CBT typically has been offered in 12 to 16
sessions, cbt interventions for substance abuse usually over 12 weeks (Carroll,
1998). The form of CBT used in NIAAA’s Project MATCH (Kadden et al., 1992) consisted of 12
sessions, administered as individual therapy, meeting once per week. A 12-session CBT for cocaine addicts suggested that this
length of treatment is sufficient to achieve and stabilize abstinence from
cocaine (Carroll, 1998).

cbt interventions for substance abuse

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. It is now believed that relapse prevention strategies must be taught to the individual during the course of therapy, and various strategies to enhance patient involvement and adherence such as increasing patient responsibility, promoting internal attributions to events are to be introduced in therapy. Working with a variety of targets helps in generalization of gains, patients are helped in anticipating high risk situations33.

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