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Cognitive Behavior Therapy for Addiction

Recognize, Avoid and Cope

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Updated April 22, 2014

Cognitive behavior therapy is mostly used to treat depression, anxiety disorders, phobias, and other mental disorders, but it has also been shown to be valuable in treating alcoholism and drug addiction, especially as part of an overall program of recovery.

Cognitive-behavioral coping skills treatment is a short-term, focused therapeutic approach to helping drug-dependent people become abstinent by using the same learning processes the person used to develop alcohol and drug dependence initially.

What Is Cognitive Behavior Therapy?

Cognitive behavior therapy is based on the idea that feelings and behaviors are caused by a person's thoughts, not on outside stimuli like people, situations and events. People may not be able to change their circumstances, but they can change how they think about them and therefore change how they feel and behave, according to cognitive-behavior therapists.

In the treatment for alcohol and drug dependence, the goal of cognitive behavioral therapy is to teach the person to recognize situations in which they are most likely to drink or use drugs, avoid these circumstances if possible, and cope with other problems and behaviors which may lead to their substance abuse.

What Are Other Approaches to Cognitive Behavior Therapy?

According to the National Association of Cognitive-Behavioral Therapists, there are several approaches to cognitive-behavioral therapy, or CBT as it is called, including Rational Emotive Behavior Therapy, Rational Behavior Therapy, Rational Living Therapy, Cognitive Therapy, and Dialectic Behavior Therapy.

What Are the Components of Cognitive Behavior Therapy?

In its use to treat alcohol and drug-dependence individuals, cognitive behavior therapy has two main components: functional analysis and skills training.

Functional Analysis: Working together, the therapist and the patient try to identify the thoughts, feelings and circumstances of the patient before and after they drank or used drugs. This helps the patient determine the risks that are likely to lead to a relapse.

Functional analysis can also give the person insight into why they drink or use drugs in the first place and identify situations in which the person has coping difficulties.

Skills Training: If someone is at the point where they need professional treatment for their alcohol or drug dependence, chances are they are using alcohol or drugs as their main means of coping with their problems. The goal of cognitive behavior therapy is to get the person to learn or relearn better coping skills.

The therapist tries to help the individual unlearn old habits and learn to develop healthier skills and habits. The main goal of cognitive behavior therapy is to educate the alcohol or drug-dependent person to change the way they think about their substance abuse and to learn new ways to cope with the situations and circumstances that led to their drinking or drugging episodes in the past.

How Long Does Cognitive Behavior Therapy Take?

Because cognitive behavior therapy is a structured, goal-oriented educational process focused on the immediate problems of the alcohol or drug-dependent patient, the process is usually short-term. Although other forms of therapy and psychoanalysis can take years, cognitive behavior therapy is usually completed in 12 to 16 sessions with the therapist.

How Effective Is Cognitive Behavior Therapy?

According to the National Institute on Drug Abuse, more than 24 randomized controlled trials have been conducted among users of tobacco, alcohol, cocaine, marijuana, opiates, and other types of substances, making cognitive-behavioral treatments one of the most frequently evaluated psychosocial approaches to treat substance use disorders.

In these studies, cognitive behavior therapy has been shown most effective when compared with having no other treatment at all. When compared with other treatment approaches, studies have had mixed results -- some show cognitive behavior therapy more effective while others show it to be of equal, but not greater, effectiveness than other treatments.

As with other treatments for alcoholism and drug abuse, including pharmaceutical treatments, cognitive behavior therapy works best when combined with other recovery efforts, such as participation in support groups.

In short, behavior cognitive therapy works well for some, but not for everyone, as is the case with all alcoholism and drug treatment approaches.

Sources:
Cognitive-Behavioral Therapy: An Overview, July 2005, National Institute on Drug Abuse
What Is Cognitive Behavior Therapy?, 2006, National Association of Cognitive-Behavioral Therapists
Clinical Research Supporting CBT, July 2005, National Institute on Drug Abuse

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