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Treating Addiction with Cognitive Behavioural Therapy (CBT)
When you come to Sanctuary Lodge, you can benefit from cognitive behavioural therapy, also known as CBT. It is a form of psychotherapy based on the interconnectedness of cognition, emotions and behaviour.
CBT is built upon the theory that flawed thoughts lead to questionable behaviours which, in turn, lead to depression, anxiety or self-harm, substance abuse and addiction. The connection between thoughts, feelings and behaviour can be visualised as a triangle, with one element at each of the triangle’s points. Influence runs in several directions, from thoughts to behaviour, behaviour to feelings, behaviour to thoughts, and so on.
CBT understands irrational thinking and harmful behavioural patterns to be a product of learning. Healthy, adaptive problem-solving and coping techniques are then developed in their place.
As part of addiction treatment, CBT sessions typically last one hour, and practitioners recommend six to 20 sessions, depending on the client’s condition and goals. (1) Thoughts, behaviours and emotions are explored and challenged during the sessions. However, the real benefit from CBT is primarily reflected in the skills and tools you would be able to use once you leave rehab and start your new, improved life. CBT is a highly structured, practical and personalised form of therapy (2).
How Does CBT Work for Addiction Treatment?
CBT is an effective therapeutic addition to the treatment of drug abuse and addiction. In CBT, you would work alongside your therapist to identify difficult emotions, recognise harmful behaviours and rationalise irrational thoughts. You will develop skills you would utilise when managing stress and pressure once you move out of the safety of the rehab clinic. Once you complete your CBT therapy programme, you would be able to identify and avoid high-risk situations, be able to control your emotions and reactions in previously tricky situations and more. (3)
Three forms of CBT have been recognised as particularly effective: motivational interviewing, contingency management and relapse prevention.
Motivational interviewing (MI) is a therapeutic approach to addressing motivational barriers or ambivalence toward treatment. The goal of MI is to bring to the surface the thoughts and feelings driving your reluctance so that you can get help and resolve this issue. Contingency management (CM) utilises positive reinforcement in encouraging sobriety and healthy behaviours.
Relapse prevention (RP) aims to help you identify and avoid stressful situations where you may end up being in danger or encounter problematic levels of stress without needing to. You would learn how to better manage your emotions during situations that would include environments in which drugs are readily available or commonly used, people who use, as well as activities linked to previous use. Alongside your therapist, you will work to develop alternative, adaptive reactions which will help you restart your life in a new, sober and healthier way where you know how to handle difficulties without needing external stimuli. (4)
The ABCDE model of CBT
The ABCDE model, developed by psychologist Robert Ellis, is a therapeutic tool used in CBT to understand, confront and change maladaptive patterns.
The ABCDE acronym defines the steps of the approach:
- A: Identifying the event activating the harmful belief
- B: Recognising the feelings triggered by the activating event
- C: Realising the emotional and behavioural consequences of the beliefs
- D: Learning to dispute the destructive idea
- E: Developing new, effective responses and thinking patterns (5)
How are CBT sessions structured?
Your therapist may begin your CBT treatment with a questionnaire or a type of an initial mood assessment to understand better your current emotional state and how you have previously acted in a variety of both happy and stressful situations. You and your therapist will together develop a treatment plan designed to address your unique situation systematically and will start working towards achieving your treatment goals.
You will both take on challenges and discuss the ways to manage difficulties better, maybe even focus on situations from your actual previous experiences. You would also develop a repertoire of cognitive problem-solving and coping tools and skills to manage difficult situations in a way that will bring you joy and positive after-effects rather than stress. (3)
How Effective Is CBT in Addiction Treatment?
Treating addictions with CBT is a relatively new approach and continues to evolve to meet most suitably the therapeutic needs of those recovering from drug abuse. Studies evaluating the role of cognitive behavioural therapy in addiction treatment focus specifically on the therapy’s efficacy in helping people who suffer from an addiction to identify triggering situations, circumstances and emotions. Strategies of refusing drugs, coping skills, and how to engage in activities not linked to drug use are included in the discussions you would be having with your therapist.
CBT is found to be beneficial because it operates on the theory that questionable thoughts, behaviours and feelings are learned and, more importantly, can be replaced by better, more positive and helpful habits.
>In addiction recovery, replacing harmful patterns with healthy and effective strategies and tools is key to long-term success.
Research has demonstrated the effectiveness of the approach, particularly when combined with various holistic and medical therapies and different forms of psychotherapy. In a meta-analysis of controlled studies on cognitive behavioural therapy in addiction treatment, 58% of participants receiving CBT progressed through recovery with more favourable results when compared with the ones who didn’t have the chance to experience and benefit from this type of treatment. (6)
The benefits of CBT in addiction treatment
The techniques and abilities developed during your cognitive behavioural therapy sessions would effectively support your long-term recovery and ease your new, brighter life. Through CBT, you would develop essential skills such as:
- How to monitor the connection between thoughts, behaviours and emotions
- Adaptive thinking patterns and behaviours
- Effective coping and problem-solving skills
- How to identify triggering situations, environments and emotions
- Drug refusal strategies
- How to recognise and manage cravings