Effectiveness of Cognitive Behavioral Therapy for Treatment of Alcohol Addiction - Literature review Example

? The effectiveness of Cognitive Behavioral therapy for treatment of alcohol addiction in clinical practice al affiliation The effectiveness of Cognitive Behavioral therapy for treatment of alcohol addiction in clinical practice 1.1 Introduction Cognitive behavior therapy can be referred to as talking therapy that assists people who are experiencing mental difficulties (Beck, 2009). The basis of cognitive behavior therapy is to make people think of what can affect how they think and how they behave. When an individual is undergoing mental stress he or she undergoes very many difficulties and behaves indifferently. The CBT practitioners work together to assist these people change how they think and how they behave (Beck, 2009). When doing this they manage to change how they act and think. CBT appears to be more effective in treating alcohol abusers and those that are undergoing depression researchers from the Rand Corporation have noted that depressive symptoms are common in individuals who abuse alcohol or any other substance (Beck, 2009). There is a direct correlation between alcohol and depression. Fifty percent of alcoholics suffer from depression at one given point in time. Alcohol and depression haven been indicated by researchers that they do not mix well though; alcohol has been seen to be a depressant. Alcoholics use alcohol as a way of controlling their depression. When alcoholism and depression exists together they are called co-morbidity because they exist together. Alcohol and depression coexists together within an individual developing a complex situation that is very difficult to treat. Treatment cannot be done separate, and successful treatment must take into account the two diseases. This paper presents a literature review on the effectiveness of cognitive behavioral therapy for treatment of alcohol addiction patients. Alcoholism and depression are disorders that commonly co-occur within an individual. The most effective way of treating these two disorders as research indicated is by the use of selective seretonic reuptake inhibitors. The effects of this kind of treatment have not been effective enough and little research has been conducted to determine its effect in the context of CBT treatment. A study conducted by a group of therapist revealed that the use of the sertraline was effective in treating alcohol addicts. This study used a sample of 82 depressor and alcohol abusers. The study participants was randomized and placed under control for 12 weeks trial with a combination of sertraline combined with individual CBT. The program focused on both alcoholism and relapse prevention. Depression and alcohol outcomes were all measured during the study and over twelve weeks sertraline was tolerated by the alcohol patients and depressions was reduced as well as the rate of alcohol consumptions (Moak, 2005). Jon and Richard (2002) conducted a study to test the hypothesis that cognitive-behavioral treatment (CBT) for alcohol dependence works through increasing cognitive and behavioral coping skills. The study used a sample of ten studies which were identified that investigated the hypothesized mechanisms of action of CBT. These studies used random sampling procedures to CBT and at least one comparison condition. The study found that though, numerous analyses of the possible causal links have been conducted to evaluate whether CBT works through increasing coping, the results indicate little support for the hypothesized mechanisms of action of CBT. The researchers thus, concluded that research has not yet established why CBT is an effective treatment for alcohol dependence. A study conducted by a group of therapists investigated the evolving work on treatment approaches for individuals with alcohol dependence and comorbid anxiety disorder, this study conducted an overview of issues related to comorbidity and its treatment, this researchers described a prototype that was combined in treating alcohol addicts usin the CBT therapy. The study found that the program is accepted by the patients undergoing intensive alcohol treatment using the CBT therapy. Roth and Fonagy (2009) conducted a study to investigate what cognitive therapy constitutes. She found that cognitive and behavior psychotherapies are based on the principles of physiological human behavior and emotions. These include a wide range of treatment from emotional disorders to individual self help materials. Roth and Fonagy (2009) states that the CBT is one of the major orientations of physiotherapy, and it represents a unique category of interventions this is because it is derived from physiological models of human behavior that entail theories of human developmental behavior. Their research concluded that CBT therapy is based on clinical applications just like the learning theory where the role of classical conditioning and operant are seen as the primary elements of learning. Early development of this theory did not look at the role of cognition and the cognitive process of treatment of emotional disorder. CBT is based on research that maintains the emotional disorder of different individuals. A study conducted by Evans (2002) presented the perspective, of CBT alcohol and drug abuse. In this research these elements are viewed as learned behaviors normally acquired through experience and exposure by an individual. When alcohol or drugs produce desired results, then it is perceived as the best way of eliciting these behaviors unlike when it results to unwanted behaviors. In this research this model has been associated with main types of learning that is learning by association and learning by consequence. Learning by associating the natural stimulus triggered by alcohol, such stimulus includes objects such as ones setting, environment friends or even the location. It may also be internal events like emotions and thoughts. In learning by consequence, alcoholics behaviors are strengthen by the consequences of alcohol negative and positive reinforcement can be used to deter some of the effects of alcohol use (Evans, 2002). Williams (2007) argued in his research, that different approach that can be based on the two cognitive type of learning are; the cure exposure approach which looks into the events that trigger the urge of alcohol within an individual and experiences that come with taking alcohol. With enough exposure the trigger within an individual eventually dies. The research studies on this approach have been fixed despite the fact that, there is the breakage of alcohol triggers and alcohol consumptions. Laborites and alcohol patients have not managed to demonstrate the effects of drinking alcohol and exposure treatment. Williams (2007) notes that, the coping skill does not attempt to reduce the impact of the triggers the approach accepts triggers, and looks for alternatives that can be used as supplements in the treatment. He adds that two approaches the contingency management and community reinforcement approach looks into the consequences of drinking alcohol instead of their antecedents. The cognitive process of treating alcohol patients use different strategies in treating the alcoholics some of these strategies include. Reducing exposure to alcohol, fostering resolutions to reduce alcohol consumption; self monitoring to examine the alcohol triggers; recognition of conditioned behaviors; identification of irrelevant decisions; coping with relapse and identification of emergencies. Marlatt and Gordon (2005) in their research reveal that, the techniques of facilitating these responses are direct instructions, use of models through role play, and rehearsal within the therapy session. Morgenstern (2000) conducted a study on the effectiveness of cognitive- behavioral treatment among the alcohol patients. He used a sample of 252 participants randomly assigned into three conditions. High-standardization CBT, low-standardization CBT, and normally treatment. There was 12 weekly individual therapy sessions. It was evident that, patients reduced the rate of alcohol consumption. Though, there were no significant outcomes in other conditions used in the study. His findings do not support the hypothesis that CBT improves the status of alcohol patients and that it will improve the outcomes. The increasing evidence of some research indicates that, the usefulness of CBT has grown in various clinics such as health anxiety, social phobia, and schizophrenia. CBT has also been proved beneficial to patients who go for psychiatric therapy. The CBT skills can be applied in treating and assessing patients improvement. The CBT model is effective in that, it provides effective psychological interventions; it provides a focus on the current problems among patients; it has a clear underlying model; it has a good structure plan of treatment, and a delivery that is built on a positive relationship with the practitioner (Morgenstern, 2000) The CBT model is based on the following principles; its purpose is for patients to learn new skills on how to manage themselves; it adopts a collaborative stand that motivates patients to work towards changing how they feel. This therapy is in great demand within the community so getting access to the facilities became difficult for many patients. Similarly, the language used in the therapy is very technical, and some patients fail to understand the whole process. The language barrier does not affect the communication process, but also the critical thinking process. In some situation, it was found that CBT leads to unhelpful thinking style, negative thoughts among patients, and arbitrary thinking leading to unrealistic conclusions (Williams, 2007). CBT is effective for treatment of anxiety, mood, personality, alcohol, abuse and other psychological factors. The process of treatment is at times manualized using techniques to treat psychological disorders. The model is effective in treating individual therapy as well as, a group of patients. Some clinics and researchers who use the model are more cognitive oriented, while others are more behavioural and other institutions combine both methods while treating patients. Various criticisms indicate that, the data obtained from CBT does not support the rate of attention and the amount of funds it receives or the psychotherapy matters like retrenchment and the weakness of CBT. The CBT interventions have been tested in to examine their utility in the world in terms of cost effectiveness. The addictive individuals benefit more from the program though review data suggests for more effort to improve on the cost effectiveness (Morgenstern, 2010). He adds that the interventions have received support though they have not received systematic reviews. Meta analysis approach has been noted to be the best analysis of CBT interventions, although qualitative research reveal that, CBT is qualitative in treating alcoholics though it produces mixed reactions (Molly, 2009). Wright, Williams, and Garland (2002) conducted a meta analysis review where he examined 26 quasi experimental trials across drug abusers. He reported a small overall effect of the CBT model a medium effect on the psychological outcome and generated a positive effects of the model. Indicated that a large group of adults alcoholics indicated positive effects of the CBT therapy. He further notes that, CBT therapy was not effective in group therapy and short period of therapy. Therefore, the study supports the use of CBT for short therapy. From the review, a number of limitations can be noted. First of all, most of the reviews failed to show how they treated the out come measures this could have led to difference views of the outcomes. There is no element of comparison among the different CBT models used in the study. The paper presents the effects of CBT therapy and does not show the individual benefits of the service to its patients. Therefore, there is need for more research on the effects of CBT therapy to alcoholics and not drug abusers in general. Most of these qualitative papers used qualitative methods of analysis of data. They had primary and secondary outcomes of the CBT as compared to other models of treatment. They had clear criteria of generating the sample size. They all had a detailed account of how data was collected. Lastly there was a positive relationship between the participants, and the researchers, this in turn made the research obtain genuine outcome from the respondents most of the trials have used CBT models. However, the results of the Meta analysis reviews reveal that there is a significant difference in the effects of CBT therapy for depression as compared to behavior therapy. Outcome measures are the effects of alcohol consumption and the effect of CBT therapy treatment among the alcoholic patients. The assessment points are the major effects the therapy has in the patients. After therapy if the patient is completely molded then the therapy is effective. Follow up activities are conducted by the medical practitioners who makes a follow up with patients to ensure that they change behavior completely. The review presents some research that presents skills that alcohol addicts learn through cognitive-behavioral approaches remain in them even after the completion of treatment. Most people getting this treatment as presented in several studies, have maintained the they gained during the treatment process. More resent research focuses on how to develop more powerful effects by combining cognitive-behavioral therapy with medications for drug abuse and with other types of behavioral therapies. The review has revealed that this current researchers are also evaluating the best ways of how to train treatment providers to deliver cognitive-behavioral therapy. References Beck, A. T. (2009). Cognitive Therapy of Depression. New York: Guilford Press. Bell, J. (1993). Doing Your Research Project (2nd Ed) Buckingham: Open University Press. Evans, M. D. (2002). Relapse cognitive therapy and pharmacotherapy for depression. Oxford: Archives of General Psychiatry Oxford University Press. Jon., M., and Richard, N. (2002). Cognitive–behavioral treatment for alcohol dependence: Journal of Mental Health,Volume 67 pg 300-400. Marlatt, G.A. and Gordon, J. R., (Eds.). (2005). Relapse prevention: Maintenance strategies in the treatment of addictive behaviors. New York: Guilford. Moak, D. (2003).Cognitive Behavioral Therapy for Depressed Alcoholics: Results of A Placebo-Controlled Trial Sertraline and Cognitive Behavioral Therapy for Depressed Alcoholics: Journal of Clinical Psychopharmacology: Vol 23 - Issue 6 - pp 553-562. Morgenstern, J. (2001). Effectiveness of cognitive-behavioral treatment for substance abuse in a community setting. Journal of Consulting and Clinical Psychology, Vol 69(6). Matt., G. (2006). Cognitive behavioral treatment of comorbid anxiety disorder in alcoholism treatment patients: Journal of Mental HealthVol. 15, No. 6 , Pages 697-707. Roth A., and Fonagy, P. (2005). A critical review of psychotherapy research. Second Edition. The Guildford Press, London. Williams, J. (2007). Cognitive Psychology and Emotional Disorders. Chichester: John Wiley and Sons. Wright, B., Williams, C. J. and Garland, A. (2002). Five Areas cognitive–behavioral therapy model in psychiatric in-patients. London. Read More