CBT for Alcoholism and Drug Addiction: Does It Work?

The high bar for addiction medications has discouraged investment by the pharmaceutical industry, and significant public sector help was required to bring many of the currently available medications for substance use disorders to market, including buprenorphine, extended-release naltrexone, lofexidine, and naloxone nasal spray. Tables 1 and 2 describe each study with respect to key design characteristics and effect sizes and are separated by posttreatment and follow-up outcomes, respectively. For outcomes of interest, biological assay/frequency measures and quantity measures are considered primary, and when available both are reported in Tables 1 and 2.

To add clinical utility to this review, effect size data will be summarized using Cohen’s generic benchmarks of “small” (d ~ 0.20), “medium” (d ~ 0.50), and “large” (d ~ 0.80).18 In discussion, we provide final remarks on for whom, how, and where CBT may work best. Cognitive behavioral therapy can be a highly effective choice for treating alcohol and substance use disorders. It can be used on its own or combined with other approaches that work together to support a person’s long-term recovery. However, it is not the only option out there, so talk to your healthcare provider about what’s available to decide what approach is best for your needs. A particular barrier to effective dissemination of CBT is the lack of a system for training, supervision, and feedback to clinicians.

Expectancies

A range of explanations have been offered including common factors and specific, yet equally effective, factors (e.g., Magill, Kiluk, McCrady, Tonigan, & Longabaugh, 2015), and it could be a combination of both. Such questions are complex, but highly significant for future clinical training, intervention refinement, and community program https://ecosoberhouse.com/ implementation. In contrast to many other therapies, cognitive-behavioral therapy for the
treatment of substance abuse disorders has substantial research evidence in
support of its effectiveness. In comparison to behavioral treatments such as the community reinforcement
approach, CBT focuses more on cognitions, beliefs, and expectancies.

This detailed analysis serves to inform the treatment process and
individualize the specific interventions and treatment plan for the client. The therapist and client can then use the results of the functional analysis
to anticipate high-risk situations and develop specific methods to avoid or
cope with them. For the cognitive-behavioral therapist, an individual’s appraisal of
stressful situations and his ability to cope with the demands of these
situations are important influences on the initiation and maintenance of
substance abuse, as well as relapse after cessation of use (Hawkins, 1992; Marlatt and Gordon, 1985; Shiffman, 1987, 1989; Wills and Hirky,
1996). Abramson and colleagues proposed that individuals develop attributional
styles (i.e., individual ways of explaining events in their lives that can
play a role in the development of emotional problems and dysfunctional
behaviors) (Abramson et al.,
1978). The basic attributional dimensions are internal/external,
stable/unstable, and global/specific. For instance, clinically depressed
persons tend to blame themselves for adverse life events (internal), believe
that the causes of negative situations will last indefinitely (stable), and
overgeneralize the causes of discrete occurrences (global).

Public Health Significance:

Programs usually include activities such as employment, education and skills training, life skills training (such as budgeting and cooking), counseling, group work, RP and a “re-entry” phase where people are helped return to their community. Psychosocial interventions for treatment of alcohol and drug problems cover a broad array of treatment interventions, which have varied theoretical backgrounds. They are aimed at eliciting changes in the patient’s drug use behaviors well as other factors such as cognition and emotion using the interaction between therapist and patient. The current meta-analysis shows that CBT is more effective than a no treatment, minimal treatment, or non-specific control. Consistent with findings on other evidence-based therapies, CBT did not show superior efficacy in contrast to another specific modality. The therapist practicing CBT will also challenge the attributional process
and emotional aftermath of a relapse.

• Substituting old habits that contribute to substance use with more positive and enduring actions enhances a person’s ability to function and aids in long-term recovery.
• There is a need for research on psychological interventions in special populations such as adolescents, polydrug misusers and in people with psychiatric comorbidity.
• As noted, we sought homogeneity in how CBT was defined via inclusion of face-to-face CBT not combined with another intervention, whether psychosocial or pharmacological.
• 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.
• Including family
  members in the planning process is important because they are often better
  able than the client to see the warning signs of an impending relapse.

Such patients may disagree that they will need to eliminate their use of psychoactive chemicals, and may decide to leave therapy if the therapist insists that the goal must be abstinence. Of course, there are some patients who are remanded for treatment who otherwise would not seek treatment on their own. They may deny that they have a problem with alcohol and other drugs, and not truly engage in the therapy process at all. The therapist’s understanding of the patient’s stage of change will be vital in helping them know just how directive to be, without going too far for a particular patient to tolerate at a given time in treatment. This sort of sensitivity may allow therapists to get the maximum out of treatment with patients who are most motivated, while retaining less motivated patients in treatment until such time as they begin to feel more a sense of ambition in dealing with their problem.

Cognitive-Behavioral Interventions – Core Youth (CBI-CY)

The intervention of this study can be used for establishing self-management and decreasing anger among patients depending on substances. Self-efficacy has been thought of as both the degree of a client’s temptation
to use in substance-related settings and his degree of confidence in his
ability to refrain from using in those settings (Annis and Davis, 1988b; DiClemente et al., 1994; Sklar et al., 1997). The role of cognitive behavioral interventions for substance abuse self-efficacy has
been examined for alcohol (Evans and
Dunn, 1995; Solomon and Annis,
1990), cocaine (Coon et al.,
1998; Rounds-Bryant et al.,
1997), marijuana (Stephens et
al., 1993), opiates (Reilly et
al., 1995), and across all of these substances of abuse (Sklar et al., 1997). This research
generally supports the hypothesis that those with lower levels of
self-efficacy are more likely to abuse substances.

• Therapies based on counterconditioning theory typically use chemically
  induced aversion or electric shock as negative consequences to be paired
  with the substance-related cues.
• “Depending on substances” vs. “abusing substances” was differentiated by the psychiatrist according to the DSM-IV-TR criteria.
• Cue exposure is another behavioural technique based on the classical conditioning theory and theories of cue reactivity and extinction12,13.
• Behavioral therapy focuses more on identifying and changing
  observable, measurable behaviors than other therapeutic approaches and hence
  lends itself to brief work.