Cognitive Behavioral Therapy to Treat Substance Abuse - Research Paper Example

? Cognitive Behavioral Therapy to Treat Substance Abuse Introduction Substance addiction and abuse is a complex illness exemplified by extreme and, often at times, uncontrollable substance craving, coupled with compulsive substance seeking and use that endures even in the face of devastating out comes. Even though it is quite easy to follow the path to substance abuse and certainly addiction, through voluntary act of taking such substances, an individual’s ability to opt not to use them over time becomes compromised and consuming and seeking these substances becomes compelling. Substance abuse behavior therefore results mainly from the long term substance exposure on the functioning of brain. Substance abuse and addiction is certainly a brain illness that affect the functionalities of the brain circuits, such as those involving memory and learning, reward and motivation, as well as inhibitory control over behavior. It is worth noting that, substance addiction and abuse are viewed as learned behaviors that are acquired through experience. Cognitive behavioral therapy treatment is an approach geared towards improving the behavioral and cognitive skills of the patient abusing substances by changing their substance use behavior. The term cognitive behavior therapy or treatment refers to the idea that behaviors and feelings are usually caused by an individual’s thoughts, and not on outside stimuli such events, situations, and people. According to therapists of cognitive behavior, individuals may not be in a position to change their situations, but they are capable of changing how they think about these circumstances and therefore change the way in which they feel and behave (Sanchez, 1996). In the treatment of substance abuse, the objective of Cognitive behavioral therapy is therefore, to teach an individual to be able to recognize circumstances in which they are most likely to use such substances, avoid these situation if possible, and how to cope with other behaviors and problems which might lead to their substance abuse. Although Cognitive behavioral therapy is often used to treat a variety of other disorders such as anxiety, phobias, depression and other mental disorders, study shows that this form of treatment is very valuable in helping individuals who are addicted to substance abuse most especially as part of an overall program of recovery (Monti., at el 1999). Finney, is of the view that Cognitive behavioral therapy is a short term, therapeutic approach aimed at helping substance dependant individuals become abstinent by applying the same learning procedure the individual used initially to develop the behavior of substance abuse(1998). Behavioral treatment therefore, assists patients of substance abuse to engage in the process of their treatment, by means of modifying their behaviors and attitudes related to substance abuse, and alleviate healthy life skills. Certainly, this form of treatment can enhance the viability of medication and assist individuals entangled in substance abuse stay in the treatment long enough to full recovery. Discussion According to Miller & Mastria, the deficits in skills for coping with the consequences and antecedents of substance abuse are considered to be a major factor in the development and endurance of the abusive behavior (1997). Accordingly, considerable effort has been devoted to evaluating the veracity of cognitive behavior coping skills treatment, to determine whether or not it has practical utility as a method of effectively mitigating the risk and curtailing substance abuse behavior. A majority of clinical research on this form of treatment have produced an overwhelming evidence of its effectiveness compared to other methods of substance abuse treatment (Monti., at el 1999). Even though there are a number of vital issues regarding the cognitive behavioral therapy that are not yet resolved, this form of treatment has a firm theoretical foundation, and the proof supporting the treatment efficacy and relapse prevention is equal if not superior to other forms of substance abuse treatment currently available. The veracity of cognitive behavioral coping skills treatment is best conceptualized in the form of psychological dependence. Individuals with substance abuse behavior may use these substances to cope with certain or most problems that they encounter in their lives. For this reason, the individual develops a behavior of substance abuse following the recurrent experience of the apparent short lived benefits of substance use, and in the absence of the coping skills, these individuals partakes substance abuse as a preferred way of dealing with problems in life (Roberts, L., at el., 1999). To the extent that substance use becomes the only means in which and individual has to cope or deal with particular circumstances, then this individual becomes psychologically dependent upon such substance. Consequently, the individual is left with no choice, and he or she is compelled to use the substance in a bid to meet or be able to face those circumstances or needs. Coping skills deficits of an individual are therefore, a major obstacle to the person’s recovery from substance abuse. Conversely, where an individual has a number of ways in which he or she can meet his or her needs, he or she then has a choice from which he or she can chose whether or not to use substances when the need arises. That said, providing coping skills training through cognitive behavior therapy or treatment is of paramount importance as these skills help an individual to develop alternative ways through which he can meet the needs and ultimately modifying the factor of psychological dependence. In its use to treat substance abuse, cognitive behavior therapy utilizes a two main components namely the functional analysis and skills training. To begin with, functional analysis involves patient and therapist working together to determine and identify the feelings, circumstances, and thoughts of the patient before and after they use the substance. This is usually the first step in helping the patient to determine the probable risks that may culminate to a relapse. This analysis may be in the form of questionnaires, structured interviews, or even structural clinical interviews aimed at identifying the circumstances in which substance abuses are likely to occur, and certainly the sought outcomes. To Annis & Martin, the inventory of the substance taking situation was and still is a useful assessment instrument for effective identification substance use antecedent (2000). In the functional assessment, the Global Appraisal of Individual Needs presents a broad based analysis of wide range of factors that may be associated with substance abuse. Issues such as the patterns of substance use, common antecedent’s situations such as thoughts, mood states, life problems and cravings for substance use and the outcome of using, must be covered by patient interviews especially if they do not utilize structured assessment instruments. Functional analysis may also involve asking the patient to anticipate circumstances in future that may present an obstacle in their effort to restrain from substance abuse. To this effect, Miller & Mastria (1997) suggest that a range of domains must be considered in search of potential antecedents to individual substance abuse and craving, as well as situational, emotional, cognitive, social, and physiological antecedents. After identifying and developing individual potential trigger situations, they can then be listed in the order of their frequency of seriousness and occurrence as a problem. In all the antecedent factors that are identified, individuals with problem of substance abuse should be asked to specify what they anticipate to achieve from substance use in each of those circumstances. It is pertinent to mention that it is not uncommon at this stage for some of the substance users to decline to identify some of their positive expectations from their use of substances since they have made up their minds to engage in the treatment of substance abuse, which is quite understandable. While undergoing cognitive behavior therapy, these individuals should be informed that whatever they attempted to achieve from substance use was not abnormal or unreasonable. Where they sought relief from depression or other social problems and perhaps used substance for more comfort, they should be told that such circumstances are rational desires which would be similar in a majority of the people when confronted with such situations and they would be driven to similar desires. Cognitive behavior therapy under the functional analysis component seeks to sensitize substance abusers that the sole problematic aspect is the use of substance in an attempt to meet individual desires. Additionally, cognitive behavior therapy seek to identify aspects that are more probable than not, to trigger a craving of substance use and develop alternative means to achieve them in treating substance abuse. In their work on cognitive behavior therapy as a mode of treating substance abuse, Miller and Rollnick suggest that the process of identifying the sought outcomes from substance abuse, and the alternative means through which those outcomes may be achieved can be facilitated and organized through the use of a scheme (1998). Through functional analysis, an individual can gain personal insight as to the cause of their substance abuse in the first place and ultimately help them identify circumstances in which the individual has difficulties coping. In skills training as a component of cognitive behavior therapy or treatment for substance abuse, the therapist attempt to help the individual to unlearn old behaviors and learn to develop habits and skills that are healthier. Basically, the objective of cognitive behavior therapy is to educate the substance dependent individual to learn novel ways that they can use to cope with the circumstances confronting them, leading them to substance abuse in the past and change their perception on substance abuse. Treating substance abuse cannot be effective therefore without coping skills training conceptualized as aforementioned in terms of psychological dependence. It is evident the most of the individuals who abuse substance do so in an effort to cope with certain or most situations in the person’s life. Deficits in coping skills are perceived as a major risk factor to individuals who abuses substance due to the possibility that these individuals may be forced to depend on this substance as the default coping strategy. Due to the fact that an individual can never develop coping skills that are more appropriate or unable to apply them even though he has learned them, due to some inhibiting factors or lack of practice, the importance of skills training comes in. Through skill training individuals with the habit of substance abuse can be taught coping behaviors which are nonexistent in the affected individual to enhance and refresh deficient behaviors and bring to the limelight and diminish the inhibiting factors. In order for individuals to become well vast and utilize these coping skills with ease while need arises, adequate practice of the taught skills cannot be over emphasized. Coping skills training involves managing thoughts and the desire or craving for use of the substance. It is very common among individuals recovering from substance abuse disorder to have cravings for the use of a particular substance. These persons are therefore taught a range of skills that enables them to manage their cravings and thoughts. According to Miller & Rollnick, this process is done through challenging them, bringing up their unpleasant experiences in their past life and they are also asked to think of different circumstances that are risky such as anger or negative thinking and exercise with the cravings and thoughts that might result from such situations (1998). Interpersonal skills training are also an important aspect of the cognitive behavior therapy in the treatment of substance abuse. These skills are necessary for an individual recovering or being treated for substance abuse to help him cope with instances in which other individuals are part of the problem or are a crucial factor in substance abuse. Substance refusal is a skill the person with a disorder of substance abuse is taught. This skill enables him to cope with offers by other individuals to use such substances as these offers are very common. Through this training client are taught to convincingly decline such offers without conveying undeceive message, and instead propose a different activity or issue that is not related to substance use, and if the person persists with the offer the individual should ask that person not to offer the substance forthwith. Active participation of the individual under the treatment of substance abuse cannot be over emphasized in cognitive behavior therapy (Marlatt & Gordon, 1995). This follows the fact that the more active they are in this form of treatment, the more likely they are to develop the sense and motivation of involvement required especially in the practice and implementing these skills. Further persons undertaking cognitive behavior therapy and actively participate in this form of treatment becomes increasingly capable of accepting responsibility for modifying their substance abuse behavior. Encouragement of individual participation and involvement in cognitive behavior therapy should be boosted through proper selection of viable skills to be taught and skills that meet the needs of the individuals undertaking cognitive behavior therapy to treat substance abuse. This can be achieved through functional analysis as aforementioned. Conclusion Indeed, Cognitive behavioral therapy is an effective way of treating substance abuse, and a viable therapeutic approach aimed at assisting substance dependant individuals become abstinent by applying the same learning procedure the individual used initially to develop the behavior of substance abuse. It is worth noting that a cognitive behavioral conceptualization of substance abuse habit has been considered as traits that are acquired and learned through operant conditions. It therefore follows that such a behavior can be changed by applications of interventions that are learning based, that is to say cognitive behavior therapy. This can be achieved through two main components namely the functional analysis and skills training. Under functional analysis the patient and therapist work together to determine and identify the feelings, circumstances, and thoughts of the patient before and after they use the substance. On the other hand skills training as a component of cognitive behavior therapy or treatment for substance abuse, the therapist attempt to help the individual to do away with old behaviors and instead learn to develop habits and skills that is healthier. Basically the objective of cognitive behavior therapy is to educate the substance dependent individual to learn novel ways that they can use to cope with the circumstances confronting them, leading them to substance abuse in the past and change their perception on substance abuse. References Annis, H., at el. (1996). Structured Relapse Prevention: An Outpatient Counseling Approach. Toronto: Addiction Research Foundation. Annis, H. & Martin, G. (2000). Inventory of Drug-Taking Situations. Toronto: Addiction Research Foundation. Daley, D. & Marlatt, G. (1997). Managing Your Drug or Alcohol Problem. San Antonio: The Psychological Corporation. Finney, J.at el. (1998). Evaluating substance abuse treatment process models: Changes on proximal outcome variables during 12-step and cognitive-behavioral treatment. Journal of Studies on Alcohol 59 (4):371–380. Marlatt, G. & Gordon, J. (1995). Relapse Prevention. New York: Guilford Press. Miller, P., & Mastria, M. (1997). Alternatives to Alcohol Abuse. A Social Learning Model. Champaign, Illinois: Research Press. Miller, W., & Rollnick, S. (1998). Motivational Interviewing: Preparing People to Change Addictive Behavior. New York: Guilford Press. Monti, P., at el (1999). Treating Alcohol Dependence: A Coping Skills Training Guide. New York: Guilford Press. Roberts, L., at el. (1999). Overcoming Addictions: Skills Training for People with Schizophrenia. New York: W.W. Norton. Sanchez, C. (1996). A Therapist’s Manual: Secondary Prevention of Alcohol Problems. Toronto: Addiction Research Foundation. Read More