Cognitive-Behavioral Therapy for Substance Use Disorders PMC Leave a comment

They also can be used episodically with clients who leave
and then return to treatment or during aftercare or continuing care
following a more intensive treatment episode. In contingency management approaches, an active attempt is made to change
those environmental contingencies that can influence substance abuse
behavior (Higgins et al., 1998). The goal is to decrease or stop substance use and to increase behaviors that
are incompatible with use.

Analyses were conducted with Wilson’s (2005) METAREG for Maximum Likelihood regression (ML; SPSS Version 24), and variables with significant regression coefficients were placed into a final predictive model along with residual variance estimates. Missing variable codes for regression covariates cbt interventions for substance abuse were mean imputed, and a predictor was removed from the analysis if imputed values reached 20% of total cases (Pigott, 1994). We conducted sensitivity analyses throughout data analysis and considered heterogeneity and moderator analyses as two primary methods for examining effect size validity.

Effectiveness of CBT for Alcoholism and Addiction

Although there are a
number of similarities across these three seminal perspectives (see Carroll, 1998), each has contributed unique
ideas consistent with its theoretical underpinnings. However, in most substance
abuse treatment settings, the prominent features of these three theoretical
approaches are merged into a cognitive-behavioral model. Mindfulness based interventions or third wave therapies have shown promise in addressing specific aspects of addictive behaviours such as craving, negative affect, impulsivity, distress tolerance.

• Addicts can learn to understand the motivations that led to substance abuse in the first place.
• Negative consequences expected
  from cocaine include global negative effects, anxiety, depression, and
  paranoia (Jaffe and Kilbey, 1994;
  Schafer and Brown, 1991).
• In June 2020, 13 percent of people in the United States either started using substances or increased their use as a way to cope with the COVID-19 pandemic.
• However, the additive effect of these combined interventions, despite clinically intuitive expectations of their compatibility, and even synergy, has not received conclusive support.
• Our writers and reviewers are experienced professionals in medicine, addiction treatment, and healthcare.

Platforms for delivering addiction interventions via technology are diverse and multiplying rapidly. In the sections below we will cover only those which (1) are explicitly or predominantly cognitive-behavioral in focus (although several include components of MI and other interventions), (2) the primary targeted outcome is alcohol or drug use, and (3) the intervention is delivered online. We include an expanded description of a computer-based CBT program developed by our research group as a possible paradigm for how CBT evolve in the future. CBT for substance use disorders includes several distinct interventions, either combined or used in isolation, many of which can be administered in both individual and group formats. Specific behavioral and cognitive-behavioral interventions administered to individuals are reviewed below, followed by a review of family-based treatments. 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.

Efficacy of MBIs Compared With TAU

The therapist must be
prepared to move from topic to topic while always adhering to the major
theme–that how the client thinks determines how the client feels and acts,
including whether the client abuses substances. In addition to increasing drug abstinence, similar voucher systems have been
effective in maintaining attendance of methadone clients at a job-skills
training program (Silverman et al.,
1996). However, in contrast to drug treatment, less evidence is
available concerning the effectiveness of such contingency management
approaches in the treatment of alcohol problems (Higgins et al., 1998).

For
those with a problem with alcohol, medication (e.g., disulfiram [Antabuse])
monitored by the spouse may be used. The client also receives training in
problemsolving and in ways to refuse requests to drink or use drugs. One recent study evaluated the effects of a voucher program in the treatment
of methadone-maintained opiate addicts with a history of cocaine use (Silverman et al., 1998). The value of the vouchers increased as the number of consecutive
cocaine-free urine samples increased.

Using CBT for Alcohol Treatment

Functional analysis is a process in CBT that involves looking at the causes and consequences of a behavior. Working together, the therapist and individual try to identify the thoughts, feelings, and circumstances that led to and followed drinking or using. Following to Gross (14), “emotion regulation refers to the process of shaping the emotions that one has, when one has them, and how one experiences or expresses these emotions.” There are three core features of emotion regulation. First, there is an activation of a goal to modify the emotion-generative process (15, 16); second, it produces an engagement of the processes that are responsible for altering the emotion trajectory; and third, there is an impact on emotion dynamics (16, 17). MT represents the secular adaptation of Buddhist contemplative practices aimed to reduce suffering and foster well-being (24).

• While there appears to be considerable overlap in high-risk situations across
  substances (Cummings and Gordon,
  1980), there are also a number of substance-specific patterns.
• While there are a number
  of different models of relapse (Donovan
  and Chaney, 1985), the two best articulated within the
  cognitive-behavioral model are those presented by Annis and Davis and
  Marlatt and Gordon (Annis and Davis,
  1988b; Marlatt and Gordon,
  1985).
• 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.
• We conducted sensitivity analyses throughout data analysis and considered heterogeneity and moderator analyses as two primary methods for examining effect size validity.
• These are presented repeatedly without the previously learned pattern of drinking so as to lead to extinction.

Individuals who experience an intense AVE go through a motivation crisis that affects their commitment to abstinence goals30,31. Dealing with substance abuse is not easy, but with all the therapies available now, it is possible. Don’t hesitate to ask for help and get treatment most appropriate for your specific situation. Unwelcome feelings and behaviors are usually a consequence of a person’s environment or past experiences.