Although empirical support for these interventions is promising, it is most often garnered through efficacy studies in which the treatment is carried out under optimal conditions. However, most SUD treatments occur in service provision settings under conditions that are far from optimal. A limited body of effectiveness research has been conducted examining these treatments without the stringent controls afforded by efficacy trials.
Cognitive-Behavioral Therapy (CBT) for Addiction and Substance Abuse
A treatment center will attempt to verify your health insurance benefits and/or necessary authorizations on your behalf. We cannot guarantee payment or verification eligibility as conveyed by your health insurance provider will be accurate and complete. Payment of benefits are subject to all terms, conditions, limitations, and exclusions of the member’s contract at time of service. Your health insurance company will only pay for services that it determines to be “reasonable and necessary.” cbt interventions for substance abuse The treatment center will make every effort to have all services preauthorized by your health insurance company. If your health insurance company determines that a particular service is not reasonable and necessary, or that a particular service is not covered under your plan, your insurer will deny payment for that service and it will become your responsibility. CBT for substance abuse equips an individual to overcome addiction by revealing the emotions and actions that lead to it.
Evidence-based practices for substance use disorders
Homework assignments can include such things as keeping ajournal of behaviors, activities, and feelings when using substances orat risk of doing so. In the brief behavioral model designed by Phillipsand Weiner, techniques such as programmed therapy and writing therapy(see Figure 4-6) make whatis typically thought of as “homework” the central concern of the therapysession (Phillips and Weiner,1966). Studies were English-language, peer-reviewed articles published from January 1, 1990, through July 31, 2019. Given the importance of experimental contrast type in estimating effect-size magnitude in clinical trials,25,26 we used this design factor as a primary subgroup variable. Studies were included if they targeted adult populations (aged ≥18 years) meeting criteria for AUD or other drug use disorder (ie, Diagnostic and Statistical Manual of Mental Disorders, Third Edition Revised through Fifth Edition) or problematic use.27 Treatment must have been identified as either cognitive behavioral or relapse prevention.
Cognitive Therapy
Whatever the origin of the deficits, a primary goal of CBTis to help the individual develop and employ coping skills that effectivelydeal with the demands of high-risk situations without having to resort tosubstances as an alternative response. The cognitive-behavioral model assumes that substance abusers are deficientin coping skills, choose not to use those they have, or are inhibited fromdoing so (Monti et al., 1994,1995). It also assumes thatover the course of time, substance abusers develop a particular set ofeffect expectancies based on their observations of peers and significantothers abusing substances to try to cope with difficult situations andthrough their own experiences of the positive effects of substances. Theyhave come to believe that substances have positive benefits that are moreimmediate and prominent than their negative consequences. In substance use-related situations, coping “refers towhat an individual does or thinks in a relapse crisis situation so as tohandle the risk for renewed substance use” (Moser and Annis, 1996, p. 1101).Cognitive-behavioral theory posits that substance users are deficient intheir ability to cope with interpersonal, social, emotional, andpersonal problems.
How Much Does Cognitive Behavioral Therapy Cost?
The apparent lack of coping skills among substance users is an importantcontributor to another key construct in cognitive-behavioral approaches,namely self-efficacy expectancies (Bandura, 1977). These expectancies refer to an individual’sbeliefs about his ability to successfully execute an appropriate response inorder to cope with a given situation. Self-efficacy expectancies aredetermined in part by the individual’s repertoire of coping skills and anappraisal of their relative effectiveness in relation to the specificdemands of the situation. Bandura has hypothesized that expectations ofpersonal efficacy determine whether coping behavior will be initiated ornot, the amount of effort that will be expended in attempting to cope, andhow long a coping attempt will continue in the face of obstacles andaversive experiences (Bandura,1977). He also suggested that self-efficacy exerts an influence onthe individual’s behavior through cognitive, motivational, and emotionalsystems (Bandura, 1977). If aperson has low self-efficacy due to a lack of necessary coping skills, shemight be expected to have negative or distorted thoughts and beliefs aboutherself and her situation, have reduced motivation to even try to cope, andmay be depressed and perceive herself as helpless.
For example, a client may be taughthow to refuse a drink in a social situation (which might include some formof assertiveness training, as described inFigure 4-20). Learning how to develop newsocial contacts with people who are not substance abusers is anotherexample. A number of published treatment manuals are available to guide skillstraining with substance users (Carroll,1998; Kadden et al.,1992; Monti et al., 1989).These manuals provide a session-by-session overview of the intervention.
AddictionResource fact-checks all the information before publishing and uses only credible and trusted sources when citing any medical data. The Verified badge on our articles is a trusted sign of the most comprehensive scientifically-based medical content.If you have any concern that our content is inaccurate or it should be updated, please let our team know at [email protected]. We may be paid a fee for marketing or advertising by organizations that can assist with treating people with substance use disorders. The team at Oxford Treatment Center is available 24/7 to answer your questions about inpatient addiction treatment and outpatient drug and alcohol rehab in Mississippi. Our admissions navigators can help you explore different rehab payment options and verify your drug and alcohol rehab insurance coverage. Traumatic experiences can drive individuals to use substances as a way to cope with the emotional pain and distress caused by the trauma.
SE has been found to be an effective intervention for opiate use disorders, especially when delivered by skilled therapists [90] and in controlled settings such as methadone maintenance. Although the following is not an exhaustive list, it does include most behavioral therapies that generally are acknowledged to have comparatively strong empirical support and which have been specified adequately. Unlike pharmacotherapies, many behavioral therapies can be used across a range of substance use disorders with fairly little adaptation [38].
- It also assumes thatover the course of time, substance abusers develop a particular set ofeffect expectancies based on their observations of peers and significantothers abusing substances to try to cope with difficult situations andthrough their own experiences of the positive effects of substances.
- Despite the importance of combined pharmacological and behavioral interventions for AUD/SUD, few meta-analyses on this intervention approach have been performed.
- CBT for AOD has a rich theoretical foundation, including general cognitive and behavioral theories, specific models of CBT for AOD (eg, Marlatt and Gordon’s Relapse Prevention Model), and numerous manuals to facilitate training and delivery with fidelity.
- Rimmele andcolleagues also recommended covert sensitization as a highly effective andportable treatment component which, unlike chemical or electric aversiontherapies, can be used at any time and in any setting as a self-controlstrategy (Rimmele et al., 1995).
- Relapse prevention also stresses the importance of preparing for thepossibility of a relapse and planning ways to avoid it or, failing this,stop the process quickly and with minimal harm when it does occur.
- Decisions about the length of treatment are made on thebasis of these assessments, rather than according to a formula or theoreticalassumption about how long therapy should take.
- Other efforts to increase access to CBT and other evidence-based treatments for SUDs are also underway.[75-77] Future research focusing on methods to bridge the gap between theory and practice in a way that supports community clinicians so that systemic change can truly be effective is of particular importance.
Don’t hesitate to ask for help and get treatment most appropriate for your specific situation. Research also proves that it is very effective in treating anxiety, reducing anxiety levels in social situations, and helping deal with phobias. CBT has some things in common with rational emotive behavioral therapy, which was developed on its basis. However, the latter mostly focuses on dealing with irrational thoughts and beliefs which lead to unpleasant consequences. The primary goals of CBT in the treatment of substance use are to improve motivation, learn new coping skills, change old habits, and learn to better manage painful feelings.
