Reducing Addiction: CBT

What does CBT aim to do for addicts?

Change the maladaptive ways of thinking and behaving associated with addiction.

What are the 2 elements of CBT for addiction?

Functional Analysis (cognitive) and Skills Training (behavioural)

What is involved in functional analysis?

1. Client and therapist identify high risk situations

2. Therapist reflects on what client is thinking before, during and after the situation

3. Warm and collaborative but not cosy relationship

4. Cognitive restructuring

What is cognitive restructuring?

Change a client’s cognitive biases by restructuring their faulty beliefs. There may be and educational element. Identifies triggers as well later problems they may still have with coping.

What is involved in Skills Training?

Replace their addictive coping mechanisms with more constructive ones. It includes:

• specific skills to help cope with situations that trigger use e.g. anger management and assertiveness

• Social skills

• Modelling from the therapist which the client imitates

Strengths

• Relapse Prevention - CBT incorporates likelihood of relapse and sees it as an opportunity for further cognitive restructuring/learning than failure

Limitations

• Short term - Cowlishaw meta analysis found that after 3 months CBT was very effective but after 12 there was no significant differences between control group

• High drop out rate - many drop out and studies have shown CBT has 5x greater drop out rate than other therapies as CBT is demanding