Behavioral therapies are often delivered using a specific manual, but theyare also adaptable to the individual client. A number of the behavioraltechniques described here are also used by therapists usingcognitive-behavioral therapy. The following sections describe how briefbehavioral therapy might be applied at different stages of treatment. Although a therapist may guide the individual in a behavioral self-controlmodel, the substance abuser maintains primary responsibility for changinghis behavior. During the course of therapy, the client and therapist meet inbrief sessions to go over homework and ensure that the client is followingthrough.
Effectiveness of CBT for Alcoholism and Addiction
For example, the relative contribution of affective and social/environmental factors can vary widely across patients. A patient with co-occurring panic disorder and alcohol dependence may be experiencing cycles of withdrawal, alcohol use, and panic symptoms that serve as a barrier to both reduction cbt interventions for substance abuse of alcohol consumption and amelioration of panic symptoms. [56] Alternatively, patients without co-occurring psychological disorders may face different barriers and skills deficits, such as difficulty refusing offers for substances or a perceived need for substances in social situations.
- The population focus is adults with a diagnosed alcohol or other drug use disorder, as well as adults with substance use that may place them a risk for related consequences.
- Moredetailed information on the assessment process in cognitive-behavioralapproaches to substance abuse and its treatment is available in a number ofsources (Donovan, 1998; Donovan and Marlatt, 1988; Monti et al., 1994; Sobell et al., 1988; and Sobell et al., 1994).
- 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).
- SE has been found to be an effective intervention for opiate use disorders, especially when delivered by skilled therapists [90] and in controlled settings such as methadone maintenance.
- The evaluation of CBT for SUDs in special populations such as those diagnosed with other Axis I disorders (i.e., dual diagnosis), pregnant women, and incarcerated individuals is beyond the scope of the current review, and thus the descriptions provided below focus on SUD treatment specifically.
Behavioral Self-Control
In addition, the patient could evaluate evidence from past holidays to compare the consequences and benefits of alcohol use in these settings. Several studies examined the effectiveness of CM as a supplement to traditional drug counseling. The studies initially provided relatively high rewards (as high as $1,000) for sustained abstinence from substance use [47-49], but recently, effectiveness studies have focused on providing low-cost CM as a more feasible addition to traditional counseling programs. Petry and Martin [15] examined the addition of CM to standard community based treatment (methadone maintenance and monthly individual counseling) for cocaine and opioid dependent patients. CM in this study was delivered through a raffle format using a fixed ratio schedule in which drug-free urine samples afforded patients the opportunity to draw from a fish bowl for prizes valued between $1 and $100; patients in the CM condition achieved longer durations of abstinence through a 6-month follow up period relative to those who did not receive CM.
Other Supplemental Therapies for Drug and Alcohol Addiction
- Although there are anumber of similarities across these three seminal perspectives (see Carroll, 1998), each has contributed uniqueideas consistent with its theoretical underpinnings.
- Most of these subgroup estimates showed acceptable homogeneity, which suggests that the selected variables were informative effect-size modifiers for the sample of clinical trials reviewed.
- CBT is a form of talk therapy that helps you explore how your thoughts, feelings, and behaviors all work together.
- Clearly,different clients will have different responses to these qualitatively differentapproaches to modifying their thoughts and beliefs.
Focusing on individuals with cannabis use disorders, Budney and colleagues developed a computerized approach encompassing MI, CBT and contingency management (Budney et al., 2015). In a randomized controlled trial, 75 adults with marijuana use disorder were randomized to 2 sessions of brief treatment versus a 9-session clinician-delivered MET-CBT approach, or a 9-session version of TES emphasizing MET and CBT. Both MET/CBT conditions included a CM component in which participants could earn up to $435 in gift cards if all urines were negative for cannabis.
- In addition, it recently has been found effective in a multi-site RCT with adolescent marijuana users [88].
- For example, the relative contribution of affective and social/environmental factors can vary widely across patients.
- Treatment engagement was very low, with only 18/96 (19%) allocated to the Snow Control program accessing a module and only 8 of the 100 allocated to control.
- The therapists intervene at different stages in the thought-emotion-behavior cycle to help recovering addicts learn the skills to choose positive thoughts and behaviors.
- The establishment of job-based reinforcements have been introduced as alternatives to aid the clinical adoption of these methods.[21, 22]Also, contingency management strategies have also been incorporated into couple’s interactions (utilizing the reinforcers available to the couple) to aid the reduction of drug use (see below).
- Figure 4-19presents a list ofsession topics (Monti et al.,1989) which served as the foundation for the CBT delivered in ProjectMATCH (Matching Alcohol Treatment to Client Heterogeneity Project) (Kadden et al., 1992), a largemultisite study of treatment matching funded by the National Institute onAlcohol Abuse and Alcoholism (NIAAA).
Benefits Of Cognitive Behavioral Therapy
