Cognitive Behavioral Therapy, commonly known as CBT, is one of the most utilized forms of behavioral therapy. It combines aspects of both cognitive therapy and behavioral therapy, and it has been shown to be very effective in individuals dealing with drug and/or alcohol dependence. It was first used to treat individuals who were in treatment for alcohol dependence and was found to prevent relapse.
What Does CBT Accomplish?
The main focus of Cognitive Behavioral Therapy is to help individuals identify, understand, and change certain thoughts and behaviors, such as those related to drug and/or alcohol use. CBT focuses on what individuals are feeling at that point in time, instead of potential causes of their substance use.
Individuals can receive CBT in different settings, such as in individual therapy, group therapy, and family therapy. Some individuals may prefer to work one on one with one therapist, and some individuals may prefer a group setting where they may have the support of their peers. It is done mostly on an outpatient basis, as this helps individuals better incorporate what they have learned into their daily lives. Therapists may provide homework regardless of the setting, so individuals can apply skills learned to their lives outside of treatment. This helps individuals become more involved in the treatment process.
The National Institute on Drug Abuse states that this type of therapy can help individuals with drug and/or alcohol dependency recognize which situations put them at the highest risk for using drugs and/or alcohol, avoid said situations if possible, and cope with behaviors that are related to their drug and/or alcohol use.
Cognitive Behavioral Therapy is usually a short-term treatment. Individuals can expect to attend anywhere from 12 to 16 sessions. This length of time, although brief, is often sufficient to provide individuals with skills that will be used well after their course of treatment has ended. It can also be used in preparation for a longer-term treatment plan. Some therapists will offer booster or refresher sessions, in which individuals can meet with the therapist to discuss any issues that may have come up after their final session. This is beneficial, as it can assist the individual in handling the issue appropriately before it has a chance to escalate.
Interventions Used in CBT
There are six interventions that therapists use in Cognitive Behavioral Therapy that are unique to the substance abuse setting and required to be used in this context:
- Functional analysis of the individual’s drug and/or alcohol use
- Training on an individual basis regarding how to manage cravings, solve problems, plan for emergencies, manage thoughts related to drug and/or alcohol use, build refusal skills, and recognize decisions that may seem irrelevant
- Examination of an individual’s cognitive processes as related to drug and/or alcohol use
- Identifying and discussing high-risk situations, both in the past and future
- Encouragement and review of the individual’s use of skills implementation outside of sessions
- Practicing skills within sessions
There are other interventions that can be used, but they are not required, such as monitoring the individual’s drug and/or alcohol use, supporting the individual’s efforts to maintain sobriety, and including the individual’s support system and/or loved ones as needed. These interventions can be helpful if, for example, individuals experience a relapse while in treatment.
Who Benefits from It?
Not everyone will benefit from CBT, however. Therapists who are skilled in this type of therapy will be able to discern during the initial assessment whether or not CBT is appropriate for the individual. If the therapist does pursue this treatment plan and the individual is not well suited for it, there is a risk that the individual will leave therapy prematurely or not respond positively. Oftentimes, CBT is used as part of a larger treatment plan that also employs the use of other treatment modalities.
Practitioners of multiple disciplines can become trained in Cognitive Behavioral Therapy. Some of the individuals who are able to provide this type of therapy include the following:
Psychologists must have doctoral degrees, such as a PhD, and have graduated from a program that has been approved by the American Psychological Association.
- Social workers must have obtained both a college degree and at least two years of graduate training in a program that has received accreditation from the Council on Social Work Education.
- Psychiatrists must obtain a medical degree, and most will have completed a five-year psychiatry residency.
- Professional counselors have obtained a doctorate, master’s, or specialist degree and must pass an examination administered by the National Board of Certified Counselors.
When individuals have completed their Cognitive Behavioral Therapy treatment plan, they will, along with the therapist, reexamine their treatment plan to determine which goals they were able to meet. This also provides individuals with an idea of which goals were not met so they may decide whether or not to seek further assistance for those issues.