Cognitive Behavior Therapy in Treating Substance Addictions - Term Paper Example

Cognitive behavior therapy in treating substance addictions Introduction A solution to human problems should be found in their minds. Cognitive behavior therapy in treating addictions to alcohol and drugs is focused on in-minds transformations. This therapy has a specific characteristic in comparison with other kinds of treatment. It implies that a person’s behavior is influenced by individual’s thoughts and no other external factors influence on it. In accordance with CBT, an individual is able to trigger inner changes for the better inside him and he can take control over his way to recovery from addiction. What is CBT? There are several types of cognitive behavior therapy acclaimed by the National Association of Cognitive-Behavioral Therapists, such as ‘dialectic behavior therapy, rational living and rational behavior therapy, or rational emotive behavior therapy’ (Dryden 2002, p. 18). The essence of these approaches is to make a patient be aware of triggers of his addiction. It is relevant to help patients to develop new strategies for dealing with stressing situations and coping with addictions, respectfully. During the process of a functional analysis, therapists makes the addict persons define their inner thoughts and ideas that occur inside of them during the process of drugs/alcohol consumption or after it. There is another option for therapists to develop a behavioral model relevant to the addicted individuals. Counselors should be able to identify risky situations when relapse may occur. In this case it is relevant to develop skills that may help a patient to overcome this risk. With this regard, it is possible to make group sessions and teach clients skill elements by means of “roleplaying and real life practice exercises that will enable them to apply these skills to meet their own needs” (Marlatt 2007, p. 32). Clients should be ensured in receiving constructive feedback from counselors. A long-lasting behavioral change may occur when self-efficacy expectations are modified. CBT is efficient for clients who are actively involved in treatment process and are willing to be responsible for their future abuse prevention. In this case, during CBT a client obtains healthy behaviours instead of maladaptive habits: “As the individual undergoes a process of deconditioning, cognitive restructuring, and skills acquisition, he or she can begin to accept greater responsibility for changing the behavior. This is the essence of the self-control or self-management approach: one can learn how to escape from the clutches of the vicious cycle of addiction, regardless of how the habit pattern was originally acquired” (Rasmussen 2000, p. 116). It is important for counselors to reread required sections of manual before each session and highlight necessary points, which have to be covered during a training session. It is important for a client to hear from counselor a natural speech and not just listening to manual citing. During each session, a counselor should inform the client about the most important issues for his daily life. At this point, client’s information and examples from his life should be used by counselors as illustrative material. Therefore, CBT is effective in case relevant measures are developed by a therapist. In order to develop a relevant treatment strategy, it is necessary to conduct more than 20 documented controlled trial tests, if to refer to data of the National Institute on Drug Abuse (The Official Website of the Institute). Generally speaking, it is also efficient to combine CBT with group support sessions and other types of support strategies. It is also important to develop a flexible approach to CBT treatment development. A flexible approach implies an individual development of CBT for every patient. The main advantage for CBT as a treatment for patients with addictions is its short time performance and a personalized treatment. Currently, CBT is widely used for patients with no psychotic disorders, or those who suffer from bipolar disorder. A shift to cognitive treatment of substance addiction has been developed within the last 20 years.  A propagation of CBT was made by the National Institute on Alcohol Abuse and Alcoholism, the National Institute on Drug Abuse and the Substance Abuse and other organizations. Still, there is a necessity to implement these principles in practice. Moreover, there is a necessity for counsellors and therapists to consider CBT approach in a wider context and apply it to ‘real clients in real settings’ (Orford 2001, p. 12). In order to cure patients from SUD it is relevant to consider emotional, psychological conditions of a patient. Therefore, a patient is not an addict, but he is a person suffering from addiction to substances that was triggered by patient’s interaction in his environment. CBT within addiction A practical implementation of CBT implies strategic development of a personalized approach to every patient. In practice, the main aspect considered by therapists is a current behavior of a patient. Nevertheless, it does not imply that every patient should be prescribed certain assumptions, such as: “I should be perfect”. It is more efficient to define individual’s ‘idiosyncratic rules or assumptions’ (DiClemente, 2003). It is relevant for therapists to develop correct questions answers in order to reveal answers of the patients. This strategy is important both for revelation of stable emotional conditions of a patient and his instantaneous ideas as well. Cognitive therapists should not ‘redirect’ or criticize the way of a patient’s thinking, he should be more focused on developing a patient’s desire to divert his attention from addictive behaviour. It is relevant for therapists to draw parallels between mental disorders and substitute usage abuse. Comorbidity between SUD and mental disorders may be treated in the process of CBT. There are three main approaches to treatment of this comorbidity: the emphasis made on SUD treatment; the emphasis made on psychiatric disorder treatment or treatment of each disorder separately (Windy 2002, p. 67). A modern paradigm of CBT is focused on a personal factor as a decisive one in development of CBT approaches. In accordance with the research conducted by (Conrod and Stewart, 2005) that “a common underlying pathogenesis explains specific patterns of comorbidity between SUDs and psychiatric disorders, but that at later stages of illness, each disorder can exacerbate the other to further complicate their course” (Conrod and Stewart 2005, p. 54). Therefore, CBT is effective in addiction treatment in case the patients are ready to “adopt the scientific method for exploring their own psychology, and who place credence in the basic theoretical approach of cognitive therapy” (An Introduction to Cognitive Therapy & Cognitive Behavioural Approaches). Patients, who do not feel comfortable about psychological therapy and cognitive introspection of their minds, will hardly find CBT method effective. Therefore, efficiency of CBT therapy can be questioned and should not be considered as a remedy for drugs/alcohol addiction treatment. If to more detailed, it is possible to claim that a certain group of patients would not benefit from CBT. These patients have experienced deep-rooted long-term problems with addictions to drugs/alcohol. Consequently, in case these patients are not treated in-time, they would suffer from addiction even after CBT. It is a well-known fact, that patients subjected to CBT have suffered from relapse in the future. Still, relapse levels are lower than after other types of psychological treatment (Marlatt 2007, p. 43). Relapse Prevention Marlatt (2007) as a representative of researchers studying relapse prevention claims that “interventions that focus on relapse prevention have been found beneficial for maintaining the effects of treatment during follow-up periods and for reducing the severity of relapse episodes that do occur, but there are diminishing returns inasmuch as these benefits have been found to decrease with increasing time since treatment completion” (Msrlatt 2007, p. 54). RP treatment has often been considered as more efficient to psychological functioning and not on substance use (An Introduction to Cognitive Therapy & Cognitive Behavioural Approaches). A major reason for relapse precipitant is negative emotions of a patient. In order to reduce risk of relapse, it is relevant for counselors and therapists to develop strategies for dealing with negative emotions of a patient. Marlatt (2007) introduces a concept of self-efficacy as an efficient factor in the process of CBT. It is also suggested that positive changes in lives of patients are helpful in dealing with substance addiction. How CBT works for current users The efficacy of CBT applied for current users of alcohol or drugs have the following structure: the therapist asks questions (implies Socrates’ method) and then intends to receive an emotional response from a client. Emotional response is very important for CBT. A success of therapy is guaranteed if there is a harmonious relation between a client and a therapist and there have been no substance abuse incidents within the last year. In case current users undergo CBT, it is relevant to them to make a clear decision to overcome their addiction. The Rational Emotive Behavioural Therapy (REBT) is a common program of CBT. A client’s behavioural and emotional problems are solved in the process of treatment. The steps made in this therapy are comprised in A-B-C-model: “This model believes that the things that people believe in are the main reasons why people are disturbed, and should not be blamed on the adversities that are experienced by the alcoholics or drug addicts. In this model, the users are taught to examine the things they believe in and do the best they can to turn those beliefs into something that would produce positive results” (King). Thus, this therapy implies a hard personal work of an addict, which will turn a client into a happy individual who is able to overcome different obstacles and accept realities of life. Personal opinion CBT is efficient for patients who have not used substances within a year. Moreover, a personal desire of clients to turn into healthy individuals from addicts is a crucial factor in successful CBT. A friendly and harmonious atmosphere of treatment sessions is a first step on the way to success. Moreover, it is relevant for therapists and counsellors to use examples from client’s life in order to help him dealing with stressing situations and adapt to life changes. It is also important to actively involve a client in the treatment process. In that case, he will be inspired and a treatment process would be more effective. Counselors implementing behavioral approaches to CBT should have good knowledge of individual’s unique needs and introduce their behavioral and psychotherapy skills. Moreover, another important factor is interpersonal skills of counselors. Therefore, counselors should develop credible treatment models and be active and willing participants of treatment process. Conclusion CBT is an effective method of substance abuse treatment. The main role therapists play for recovery of addicted patients is as follows: they may help to substitute ways of behavior under conditions of situations which triggered usage of drugs or alcohol. Moreover, therapists train patients to remain more stable to stressing situations and not to rush into addictive substances usage. Counselors should be responsible for making a decision whether a client would benefit from CBT or not. Therefore, CBT as a successful method may be guaranteed by a tripartite cooperation of a counselor, a therapist and a client. Works cited 1. An Introduction to Cognitive Therapy & Cognitive Behavioural Approaches. [online]. Available at: . [Accessed 05 April, 2011] 2. Conrod, P. J., Stewart, C., 2005. A Critical Look at Dual-focused Cognitive-behavioral Treatments for Comorbid Substance Use and Psychiatric Disorders: Strengths, Limitations, and Future Directions. Journal of Cognitive Psychotherapy, 19, p. 52+. 3. DiClemente, Carlo C., 2003. Addiction and Change: How Addictions Develop and Addicted People Recover. New York: Guilford Press. 4. King, Chy. Cognitive Behavioral Therapy And The Treatment Of Addiction. [online]. Available at: [Accessed 05 April, 2011] 5. Marlatt, A., 2007. Relapse Prevention: Maintenance Strategies in the Treatment of Addictive Behaviors. Guilford Press. 6. National Institute on Drug Abuse. [online]. Available at: [Accessed 05 April, 2011] 7. Orford, Jim., 2001. Excessive Appetites: A Psychological View of Addictions. 2nd ed. Chichester, England: John Wiley & Sons. 8. Rasmussen, S., 2000. Addiction treatment: theory and practice. Sage. 9. Windy Dryden, 2002. Fundamentals of Rational Emotive Behaviour Therapy: A Training Manual. 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