Lecture Notes on Cognitive Behavioral Therapy for Substance Abuse

Flashcards covering vocabulary terms and definitions from lecture notes on cognitive behavioral therapy (CBT) for substance abuse.

Operant Learning Treatments

Treatments based on theories of operant learning, including contingency management, behavior contracting, community reinforcement, and behavioral self-control training.

Contingency Management

An active attempt to change those environmental contingencies that can influence substance abuse behavior, with the goal of decreasing or stopping substance use and increasing behaviors that are incompatible with use.

Functional Analysis

Examines the relationships among stimuli that trigger use and the consequences that follow to provide important clues regarding the meaning of the behavior to the client, as well as possible motivators and barriers to change.

Voucher Program

Clients who provided cocaine-free urine samples received vouchers that had monetary value, and the value of the vouchers increased as the number of consecutive cocaine-free urine samples increased.

Methadone Take-Home Privileges

Providing methadone take-home privileges contingent on drug-free urine samples among methadone clients with persistent multiple drug abuse resulted in marked reductions in drug use.

Contingency Management System

A system incorporated into treatment where homeless substance abusers were enrolled in an intensive day treatment program, and a subgroup was involved in a contingent work therapy and housing program, where remaining substance-free allowed them to stay in the program and housing.

Naturalistic Contingencies

Include threatened loss of job, spouse, or driver's license and were positively related to treatment outcome among alcohol users.

Behavior Contract

A written agreement specifying the target behavior to be changed, the contingencies surrounding either changing behavior or not, and the timeframe in which the desired behavior change is to occur.

Behavioral Self-Control Model

Although a therapist may guide the individual in a behavioral self-control model, the substance abuser maintains primary responsibility for changing his behavior.

Initial Session in Brief Behavioral Therapy

Involves an exploration of why the client is seeking treatment, areas of concern about substance abuse, situations in which they use excessively, and the consequences they experience, involving an abbreviated functional analysis.

Antecedents

Activating situations or life events that trigger strong feelings.

Cognitions

The individual's opinions, thoughts, or attitudes that serve to filter and distort the perception of the antecedents.

Behavior

The individual's observable actions and emotional reactions that result from their beliefs and emotions.

Cognitive Restructuring

Changing the client's thought patterns.

Cognitive Therapy

A therapeutic approach where the therapist challenges a client to look at alternative ways of seeing the same event and may assign homework to test the truth of their cognitions.

Rational-Emotive Therapy

A therapeutic approach where the therapist informs the client of the irrationality of certain types of beliefs that all people are prone to.

Cognitive-Behavioral Theory

The integration of principles derived from both behavioral and cognitive theories.

Attribution

An individual's explanation of why an event occurred, which can be internal/external, stable/unstable, and global/specific.

Cognitive Appraisal

The process of evaluating the person-environment relationship in terms of its relevance for well-being.

Coping Behaviors

What an individual does or thinks in a relapse crisis situation to handle the risk for renewed substance use.

Self-Efficacy

An individual's belief that he can successfully perform a specific behaviour in a particular situation.

Substance-Related Effect Expectancies

Beliefs about the effects of drug use.

High-Risk Situations

Situations in which substances are abused; characterized by positive social experiences, negative emotional states, or negative physical states.

Cognitive-Behavioral Model Assumptions

Deficient in coping skills, choose not to use those they have, or are inhibited from doing so; have developed a particular set of effect expectancies based on their observations and experiences.

Essential Elements of Cognitive-Behavioral Interventions

The key ingredients that distinguish CBT from other therapies, including a functional analysis of substance abuse, individualized training in coping skills, examination of cognitive processes, identification of high-risk situations, encouragement of extra-session skills implementation, and practice of skills within sessions.

CBT Therapeutic Goals

Recognizing situations in which they are likely to use, finding ways of avoiding those situations, and coping more effectively with situations, feelings, and behaviours related to their substance abuse.

Functional Analysis of Substance Abuse Behavior

Identifying the antecedents and consequences of substance abuse behaviour, which serve as triggering and maintaining factors.

Coping Skills Training

The therapist teaches the client specific behavioural skills for forming and maintaining interpersonal relationships; skills training sessions follow a relatively standardized format.

Assertiveness Training

The client is encouraged to disclose and express emotions and needs, to stand up for his rights, to do what is best for himself, and to express negative emotions constructively.

Relapse Prevention

Focuses on teaching clients how to anticipate and cope with the myriad problems they are likely to encounter when attempting to give up or reduce their substance abuse.