Cognitive Behavioral Therapy

Cognitive-behavioral therapy is a form of psychotherapy that is used to teach and encourage individuals to reduce or stop their unhealthy drug use. CBT focuses on thoughts and their effect on how we feel and what we do. It is based on the cognitive model of emotional response. This model describes how our thoughts cause our feelings and behaviors and influence our emotional and behavioral reactions to situations. During substance addiction, for example, an individual’s perceptions can become distorted or dysfunctional. In CBT,  the individual can learn to identify and evaluate their thoughts and correct their thinking so that it is more consistent with reality. When they do so, the individual usually experiences less distress and can behave more functionally.

Changing Behaviors

Individuals in CBT learn to identify and correct their problematic behaviors by applying strategies such as planning time for non-drug related activities and avoiding or leaving high-risk situations that may involve drug use. The primary goal of CBT is to stop drug addiction, address other problems that co-occur with it, and prevent relapse. A central element of CBT is anticipating problems that are likely to occur and improving the patient’s self-control by helping them develop effective coping strategies.

Techniques include discussing the positive and negative consequences of drug use, recognizing cravings early, identifying situations that might put one at risk for drug use, and developing coping strategies. To illustrate the importance of these techniques, imagine walking down a street. You see a trigger, such as a bar, and then you start thinking about alcohol. Next, you start craving alcohol, cannot get it out of your head, or feel like it is calling to you. Because a trigger is involved and there is a high association with drug use, this is a high-risk situation. As mentioned, CBT provides patients with tools to resist these cravings such as engaging in non-drug-related activity, thought-stopping, urge surfing and practicing mindfulness.

Changing Perceptions

In Cognitive Behavioral Therapy, the patient also learns to recognize and change their distorted thoughts or beliefs, which can affect their understanding of themselves, their surroundings, and other people. To correct these perceptions, therapists use a questioning process to help patients understand their automatic thoughts and shift their thinking to a healthier perspective. For example, most emotional and behavioral reactions are learned. Therefore, CBT can help patients unlearn their unwanted reactions and learn a new way to react. CBT focuses on the patient’s goals and is structured to show the patient how to think or behave in ways to reach their goals. It helps individuals identify and unlearn their addictive behavior, replace it with healthy behavior and progress towards recovery.

Relapse Prevention

Research shows that the strategies individuals learn in CBT will remain even after completion of the therapy. In particular, a focus on relapse prevention helps prevent the occurrence of initial lapses after an individual has made a commitment to sobriety. Many of these lapses occur in high-risk situations which CBT can help avoid.

CBT also helps prevent a lapse from escalating into a full-blown relapse. Often, individuals find themselves in escalating circumstances that they cannot effectively handle. This is commonly due to not seeing the early warning signs. In CBT, patients are taught cognitive therapy procedures which inform them about addiction, triggers, cravings, and using cognitive skills to control their thoughts.

CBT is structured, goal-oriented and focuses on the immediate problems faced by substance abusers entering addiction treatment. It is structured around the patient’s needs and directly addresses specific techniques to achieve sobriety. It has been shown to have long-term effectiveness, both in individual and group sessions. CBT is also a collaborative effort between the patient and therapist, in which the patient expresses concerns, learns strategies, and then implements them while the therapist teaches and supports the patient. It is based on the idea that our emotional and behavioral reactions are learned, therefore, maladaptive thoughts and behaviors can be identified and unlearned. CBT is about understanding and implementing the necessary changes to achieve a life of sobriety.

"COGNITIVE MODEL." Beck Institute. Beck Institute for Cognitive Behavior Therapy, n.d. Web. 10 Mar. 2017.

NIDA (2012). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition). Retrieved March 10, 2017, from https://www.drugabuse.gov/publications/principles- drug-addiction-treatment-research-based-guide-third-edition