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Cognitive Behavioral Therapy and Drug Addiction

As an Alternative Treatment for Addiction, Cognitive Behavioral Therapy is Proving to Increase the Chances of Long-Term Sobriety

If you are seeking a non-NA alternative drug recovery program, chances are that you have heard the phrase Cognitive Behavioral Therapy (CBT) before. This part of the non-twelve step recovery effort focuses on the notion that overcoming dependence and maintaining long-term sobriety is about more than just ‘going cold turkey,’ it is about being able to say goodbye to unhealthy behaviors and moving on without relying on illicit substances to bring about positive changes.

Understanding the Issue

CBT is about understanding and providing insights as to why a person abuses drugs or alcohol in the first place. What is it that drives the compulsion? The physical dependence on illicit substances is not the ‘problem,’ but rather a serious issue resulting from the constant underlying needs. It is possible to have a patient undergo withdrawal and be completely physically independent from drugs or alcohol, but unless there are strategies in place to ensure that the patient stays sober in the future, a relapse is likely. Simply put, patients have to understand how to replace their addictive behaviors with a positive alternative.

What is CBT?

Before you can understand why so many non-AA or non-NA programs advocate CBT, you have to understand what it is. It is a form of psychotherapy. According to the definition from the National Association of Cognitive Behavioral Therapists (NACBT), this form of therapy emphasizes the importance of thinking about what we do and how we feel. CBT is a relatively short-term, focused approach that helps users understand and recognize specific situations in which they are prone to engage in addictive behaviors. By identifying such situations, it becomes easier to avoid them when appropriate or deal with them in a healthy manner.

It is interesting to note that CBT is not a distinct therapeutic technique that can easily be identified. Rather, it is a general term for a classification for a number of similar therapies. These different therapies include Dialectic Behavior Therapy, Rational Living Therapy, Rational Emotive Behavior Therapy, Cognitive Behavioral Therapy, and Rational Behavior Therapy. When used as a part of an overall recovery program, it has proven extremely promising.

Key Components of CBT

Cognitive Behavioral Therapy has two key components: skills training and functional analysis.

We look at both of them in a bit more detail:

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Functional analysis – Both the therapist and the patient work together to identify circumstances, thoughts and feelings that the patient experiences before and after he or she uses illicit substances. This will help the patient understand risky behaviors and choices that may potentially lead to a relapse. Especially during the early treatment phase, this functional analysis is critical. Not only will it identify potential triggers, but also allows patients to understand and avoid high-risk situations. It also provides insights as to why the patient turns to drugs or alcohol in the first place. Is it because of achieving euphoria not otherwise available? Is it about escaping from reality? Perhaps it is about coping with interpersonal difficulties. Regardless of the trigger, it is important that both parties come to an understanding of the issue.

Skills training – This is the step where the patient will begin to unlearn old destructive habits and come up with new and healthier ways to replace these old habits.

The reasons that a patient may have turned to drugs to deal with intrapersonal or interpersonal issues may include:

Never having learned effective strategies to deal with challenges that people face in their adult life. Especially those who started substance abuse early (during adolescence) often have no healthy ideas how to deal with problems.
Chronic involvement in a drug-using lifestyle. Even if the user once had effective strategies to deal with stress and challenges at one point, the constant drug seeking, drug using and periods of recovering from use, may have replaced any other effective coping mechanism.
Drug abuse and other problems may have weakened the ability to use effective strategies that the patient may have learned in the past.

Relevant Features of Cognitive Behavioral Therapy

There are a number of important factors that have to be taken into consideration before using CBT.

These are a few of the key components:

It is short-term – Successful alternative drug recovery programs do not talk about recovery in weeks, but rather in months and years. However, CBT has a specific point where the formal therapy is going to end, meaning it is time-limited. This is not a never-ending treatment approach.
It is effective – Because CBT is effective within this relatively short period of time, it is an attractive approach for alternative treatments to consider. There is solid empirical support and rigorous clinical trials that have proven it to be effective.
It is structured and directive – Once every session begins, there is a specific agenda and specific concepts or techniques that are used during every session. The focus of Cognitive Behavioral Therapy is what the client wants, not what the therapist believes that the client’s goals should be. The person struggling with dependence reveals his or her goals to the therapist and the CBT therapist directs the patient in such a way that they can attain those goals.
It is inherently flexible – Flexibility plays a key component in Cognitive Behavioral Therapy. Even though results are positive in conjunction with long-term, inpatient recovery programs, its effectiveness works with either individual or group sessions. Even outpatient programs may benefit from it.
A collaborative effort – This is not a method that only requires passive participation from one of the two participants. The patient needs to share what he or she wants and the therapist will assist in achieving those goals. The patient expresses concerns, learns and implements. Meanwhile, the therapist listens, teachers and encourages.
Based on an educational model – CBT is based on the notion that the vast majority of our emotional and behavioral reactions are learned. The goal is to identify maladaptive behavior, unlearn it and come up with an alternative method of reacting to certain triggers, which proves healthier in the future. Because of the educational component, even with a short-term program, it can lead to long-term results. This is about understanding what needs to change in order to seek the desired outcome in the future.

Unlearn the Old – Learn the New

In summary, Cognitive Behavioral Therapy is an evidence-based form of therapy. It helps the patient identify and unlearn addictive behavior and replace this with healthier behavior that puts them on the path towards recovery. Learn more about how the various methodologies of Cognitive Behavioral Therapy are applied to drug and alcohol rehabilitation, and what it can do for you.