Cognitive Behavioral Therapy CBT for Addiction & Substance Abuse

The approach developed by Beck and colleagues to achieve the goal of asubstance-free life is referred to as cognitive therapy (Beck et al., 1993; Beck and Liese, 1998), while Ellis’ approach is known asrational-emotive therapy (Ellis et al.,1988). Generally, the therapist takes a more active role in cognitivetherapy than in other types of therapy, depending on the stage of treatment,severity of the substance abuse, and degree of the client’s cognitivecapability. For those clients who are married or in a relationship, marital counselingand communication skills training are provided to enhance the quality of therelationship and reduce the stress of substance-related arguments. Couplesare trained to give each other positive attention through compliments,appreciation, affection, and offers to help.

  • The significantother could be taught to positively reinforce a client’s reduceddrinking or abstinence and not to argue with her drinking when she isintoxicated, but rather to approach her when she is sober and providepositive feedback.
  • In addition,the therapist might provide the client with self-help manuals thatoutline the specific steps in the behavioral self-control process.Self-monitoring of substance abuse behavior is one form of writtenhomework common in behavioral approaches; other types of homework mightalso be used.
  • Close inspection of the medication management protocol for this study suggests it was a systematic, intensive, and rather robust intervention74,75 not readily comparable to standard clinical care.
  • CBT for addictions has a well-established evidence base, but this literature continues to evolve (Carroll & Kiluk, 2017).
  • Common elements of behavioral treatments based on theories ofoperant learning include contingency management, behavior contracting, communityreinforcement, and behavioral self-control training.

Efficacy for Treating SubstanceAbuse

Whereas the internal, global, andstable attribution for the use of alcohol is likely to lead to feelings ofhopelessness and a return to drinking, the external, specific, unstableattribution is likely to lead to greater efforts to cope with similarsituations in the future. Meaning  These findings suggest that best practices in addiction treatment should include pharmacotherapy plus cognitive behavioral therapy or another evidence-based therapy, rather than usual clinical management cbt interventions for substance abuse or nonspecific counseling services. Therapy can be a helpful tool in managing mental health symptoms and navigating difficult life transitions, such as when you quit drinking alcohol or using drugs. There are several types of therapy used in addiction treatment, and one of the most effective is cognitive behavioral therapy (CBT). This article will discuss the use of CBT in addiction treatment and teach you how to determine if CBT is the right therapy approach for you.

Effectiveness of CBT for Alcoholism and Addiction

Here, results suggested no unique benefit of adding CBT to pharmacotherapy compared with other evidence-based behavioral modalities. Although there may be evidence of some advantage for contingency management,72 removal of contingency management trials in this review did not change our substantive conclusions. This suggests that CBT is not superior to other evidence-based behavioral treatments for addiction, yet when combined with the aforementioned superiority to usual care, we suggest that clinicians favor an evidence-based behavioral therapy, CBT or otherwise, in conjunction with pharmacological treatments. To our knowledge, this is the first targeted meta-analysis of CBT in combination with pharmacotherapy for adults with AUD and other SUDs to summarize the data in a manner relevant to clinical practice guidelines.

cbt interventions for substance abuse

Primary Study Inclusion

Common elements of behavioral treatments based on theories ofoperant learning include contingency management, behavior contracting, communityreinforcement, and behavioral self-control training. The following sectionsdescribe some of the elements used in brief behavioral therapies based on theoperant learning model. The COMBINE study[51] was designed to evaluate the efficacy or pharmacotherapy, behavioral therapy and their combinations for treatment of alcohol dependence and to evaluate placebo effect on the overall outcome. This large RCT involved 1383 patients with the diagnosis of alcohol dependence, recently abstinent from alcohol. No combination was more effective than naltrexone or combined behavioral intervention (CBI) in the presence of medical management. However, CBI alone was less effective (e.g., resulted in lower percent days abstinent) than medical management and placebo.

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By the sixth 1-hour treatment session, they nolonger reported either subjective highs or physiological withdrawal. By the15th session, all clients reported that they no longer experienced cravingwhen presented with the drug-related cues. Clients who received https://ecosoberhouse.com/ the cueexposure as part of their standard outpatient treatment for cocaine use werealso less likely to drop out of treatment and had more cocaine-free weeksthan did clients attending the same outpatient program but who did notreceive cue exposure.

cbt interventions for substance abuse

A Case Study Using CBT

In this procedure,the client is asked to imagine as vividly as possible a sequence of eventsthat begin by seeing his favorite bar; this is typically accompanied byincreased craving. As the person proceeds further in imagining entering thebar, sitting down, ordering a drink, and so on, the initial sense of cravingshifts to mild discomfort. As he visualizes beginning to take a drink andtastes the alcohol, he is then asked to imagine becoming violently sick andvomiting (Rimmele et al., 1995). This manuscript offers a narrative overview of CBT efficacy for consideration among researchers, clinicians, and other community stakeholders.

  • For example, improvement in the quality of individuals’ coping skills following computerized CBT was found to mediate treatment effects on abstinence from drugs, satisfying all criteria in the causal chain (Kiluk, Nich, Babuscio, & Carroll, 2010b).
  • CBT therapy is widely available as part of inpatient, outpatient, individual, and group therapy programs.
  • Some clients continue to use skills that areappropriate at an earlier age but are no longer appropriate or effective.Others have appropriate coping skills available to them but are inhibitedfrom using them.
  • At the broadest level,they are considered either interpersonal (i.e., involving a present orrecent interaction with someone else) or intrapersonal-environmental (i.e.,factors that are either internal to the individual or reactions tononpersonal environmental events).
  • The following sectionsdescribe some of the elements used in brief behavioral therapies based on theoperant learning model.

Clinical Elements of CBT for SUDs

Benefits of Cognitive Behavioral Therapy

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