Cognitive Behavioral Therapy

What is CBT?

Cognitive-Behavioral Therapy is a method of treatment that focuses primarily on relapse prevention to assist those who are addicted to various drugs or behaviors in changing their patterns and reactions to various thought processes. According to NIDA, CBT teaches individuals how to recognize and correct behaviors that are problematic by applying various skills that can effectively stop drug abuse or to address various problems that are associated with drug abuse. This form of treatment focuses on examining:

The relationship that occurs between a user’s thoughts, feelings and reactions or behaviors.
Patterns of thought that are self-destructive and which cause negative reactions.

According to the National Alliance on Mental Illness, people often have irrational beliefs that cause negative reactions or behaviors. For instance, the following may occur:

An individual with panic attacks may irrationally believe that, “I am in danger.”
An individual who is depressed may irrationally believe that, “I am worthless.”
An individual who is addicted may irrationally believe that, “I need this drug to survive.”

These thoughts are responsible for poor behaviors such as panic, anxiety, sadness, drug use or other forms of self-destruction. CBT focuses on helping the patient to challenge their beliefs in a way that helps them to realize that their thought processes are not always correct and that they do not have to act destructively against these thoughts. The methods in which a therapists helps to coerce the thinking of the patient vary from one user to the next.

How Does CBT Work?

The theory behind CBT is that patients can learn how to perceive emotions that may provoke negative or unwanted behaviors. When an individual understands that the thoughts that are occurring are likely to evoke unwanted response, they can learn how to moderate the behavioral response so that a negative outcome does not occur. According to the Beck institute, “when people are in distress, their perspective is often inaccurate and their thoughts may be unrealistic.” CBT focuses on helping people to realize that these thoughts are unrealistic and that there is no need to respond behaviorally in a negative manner to a potentially unrealistic thought.

Getting Ready for Treatment

In cognitive behavioral therapy you will work closely with a counselor to understand your substance abuse triggers and more.

If your or someone you love is considering CBT as a means of overcoming an addiction or substance use disorder, there are some steps that you can take to prepare for treatment. The first step of the treatment process is to set goals for yourself and your recovery. You should ask yourself what it is you want to change, what you expect from treatment and where you would like to be at in terms of your relationships, your sobriety and your continued recovery. Consider the following before you get help:

What changes do you want to make to improve your life?
What symptoms of your addiction are most troublesome or debilitating to you?
Where could you make improvements that may help to reduce your addiction?
Are there any specific bad habits that you would like to change?
What are your goals?

Of course you may not have all the answers at this point—that’s o.k.! Cognitive-Behavioral Therapy can help you to hammer out some of the details as you work with a therapist to elaborate on your goals, your behavioral changes, your habits that should be changed and other aspects of your recovery—this is just the beginning.

Therapists Encouraging Patients to Become Advocates

Much of what CBT involves in the therapist working very closely with the patient to help him become his own advocate for recovery and positive behavioral change. Therapists help patients to:

Define problems that have been encountered.
Identify behaviors that have interfered with the individual’s ability to effectively solve problems on their own.
Learn how to make changes to the thoughts or actions that occurred in order to prevent future inhibition of self-sustained problem solving.
Learn to recognize how to make small changes in thinking that can result in big rewards in terms of behavioral response.
Become advocates for their own recovery.

Therapists encourage patients to learn how to advocate for their own recovery in a way that will help them to later recognize, revert, change and grow in their thought processes without reacting in a way that is likely to result in relapse or the derailment of their recovery. In time, patients understand how they can change their patterns of thinking to avoid conflict or unwanted behavioral response.

Are Medications Used?

CBT is not about medications—this treatment is solely backed by a therapist. However, many types of addiction respond well to the use of a combination approach to treatment which includes both Cognitive-Behavioral Therapy (or other psychotherapy approaches) as well as medical intervention. Certain medications can be used to treat the addictions that are widely treated using CBT methods. According to Harvard Health, CBT helps patients to recognize and avoid potential triggers that could lead to relapse. The process involves helping the patient to learn how to cope with these triggers without the use of drugs or alcohol. However, the following medications may also be used in conjunction with this type of treatment:

Disulfiram
Topiramate
Modafinil
Depression medications
Anxiety medications
Methadone
Suboxone
buprenorphine

Types of Addictions Treated

According to the National Institute on Drug Abuse, Cognitive-Behavioral Therapy is used to treat an array of addictions including behavioral addictions as well as substance use disorders. Some of the most common addictions that can be treated using CBT include:

Alcoholism
Marijuana Addiction
Cocaine Addiction
Methamphetamine Addiction
Prescription Drug Addiction
Gambling Addiction
Sexual Addictions

According to NAMI, Cognitive-Behavioral Therapy has been proven useful in the treatment of various types of phobias, behavioral disorders, anxiety disorders, PTSD and OCD as well as many forms of substance use and abuse. This type of treatment is also being used in moderation to treat schizophrenia although prevent success has yet to be fully documented in the United States.

Relapse Prevention

Cognitive-Behavioral Therapy is heavily focused on relapse prevention. The relapse prevention model focuses on helping patients to recognize risky situations and learn how to effective cope with these situations without the use of drugs or alcohol. According to Dr. Mary E. Larimer, relapse prevention methods in CBT focus on enhancing the self-efficacy of the patient while eliminating the myths that may exist in terms of the drug or alcohol use and helping the individual to manage lapses in treatment that could derail recovery. Relapse prevention is about helping the patient to understand the addiction, the triggers and the proper response so that the risk of relapse is reduced or eliminated completely.

Unfortunately, there is no steadfast way to help those who are addicted. CBT, like other methods of treatment, is a slow and steady process that will require time and commitment in order to be effective. Even with a great commitment, proper support and guidance, and medical care, there is a risk that patients will relapse. If you or someone you know is in treatment, don’t let relapse keep you from continuing down the right path. Relapse is like a hiccup, it happens, it interferes with your recovery, but it’s not the end of the world. There is hope after relapse has occurred as long as you’re willing to pick up where you left off and do your best to overcome the addiction.