Generally, the therapist takes a more active role in cognitivetherapy than in other types of therapy, depending on the stage of treatment,severity of the substance abuse, and degree of the client’s cognitivecapability. The CRA model has been modified into the Community Reinforcement and FamilyTraining procedure (CRAFT) (Meyers etal., 1996). The client’s significant others and family members,who are an integral part of this approach, receive training in behaviormodification and enhancing motivation.
Cognitive Appraisal
These approaches attemptto deal directly with a number of the cognitions involved in the relapseprocess and focus on helping the individual gain a more positiveself-efficacy. In comparison to behavioral treatments such as the community reinforcementapproach, CBT focuses more on cognitions, beliefs, and expectancies. Also, CBTgenerally does not incorporate contingency management approaches such as the useof vouchers to reinforce desired behaviors. CBT is usually confined to thetreatment session https://ecosoberhouse.com/article/making-living-amends-during-addiction-recovery/ (although therapists often give homework to clients to becompleted outside the therapy session), whereas the community reinforcementapproach stresses the importance of incorporating interventions into real worldsettings and taking advantage of community resources. Figure4-18lists a number of features thought to beunique to cognitive-behavioral interventions. Attributional processes and emotional responses also play a role in anindividual’s decision to use (Marlatt andGordon, 1985).
Cognitive Behavioral Therapy And Addiction Treatment
An alcohol-dependent client,for instance, may believe that he drank because he was weak (an internalattribution) or because he was surrounded by people encouraging him to havea beer (an external attribution). He may believe that his failure tomaintain abstinence shows that he is a weak person who can never succeed atanything (a global attribution) or cbt interventions for substance abuse that a drinking episode does notrepresent a general weakness, but was instead due to the specificcircumstances of the moment (a specific attribution). He may believe thatthe cause of his slip is something he cannot change (a stable attribution)or that the next time, he will catch himself and exert better copingresponses (an unstable attribution).
Does Insurance Cover Cognitive Behavioral Therapy in Rehab?
As part of cognitive restructuring, expectancies, or beliefs about the consequences of use, are another important target for intervention. It is not uncommon to find that patients maintain a belief that use of a particular substance will help some problematic aspect of their life or given situations. For example, a patient may believe that a family holiday would not be enjoyable without alcohol use. Similar to cognitive restructuring techniques, evaluating evidence for expectancies and designing behavioral experiments can be used to target this issue. In this instance the patient would be encouraged to refrain from drinking at the holiday party and assess the degree to which the event was enjoyable.
The clientis given an overview of the session, describing the area to be addressed andthe rationale for the specific intervention to be used. This is facilitatedby skill guidelines that focus attention on the most important aspects ofthe approach as it applies to substance abuse. After discussing the issuesinvolved in the session, the therapist models the effective coping skill forthe particular topic. The therapist then asks the client to participate in arole-playing scenario in which he can rehearse the new coping behaviors.
- Cognitive behavior therapy has existed for more than 50 years, and many pieces of research have been carried out about its use for various conditions.
- That these basic CBT components were detectable in less than 6% of all sessions rated suggests very limited success in disseminating CBT to the clinical community, at least in the settings included in those studies.
- Triggers — situations that “trigger” cravings throughout the day — keep many addicted people from getting sober.
- CBT therapy can be conducted in individual and group sessions, making it very flexible, unlike some other psychotherapies.
The accomplishment of these homework tasksserves as a point of discussion to reinforce the client’s growing sense ofself-efficacy. At the broadest level,they are considered either interpersonal (i.e., involving a present orrecent interaction with someone else) or intrapersonal-environmental (i.e.,factors that are either internal to the individual or reactions tononpersonal environmental events). There are a number of more specificsituations within each of these broader categories. These situations includemany emotional, interpersonal, and environmental settings in which peoplecommonly abuse substances and where they are likely to relapse. These situations also serve as thefoundation from which a number of measures of substance-relatedself-efficacy have been developed (Annisand Davis, 1988b; DiClementeet al., 1994; Sklar et al.,1997).
A Case Study Using CBT
- Clearly the fullintervention plan would require further assessment and a functionalanalysis; however, a direction for further treatment can already be seen inthis brief interchange.
- “Many medical conditions can limit your activities. CBT can help you adjust to your diagnosis, cope with the new challenges, and still live a meaningful life, despite the limitations,” says Burbridge.
- The focus of the therapy might be tonegotiate with the client to accomplish these other goals by reducinguse.
With the right support and the essential tools for recovery, the next attempt could be the one that endures. If your insurance doesn’t cover all of your therapy costs or if you don’t have insurance, there are other ways to pay. Some therapists also offer payment plans, scholarships, and sliding-scale fees based on income.
