Cognitive Behavioral Therapy CBT: What It Is & Techniques

In the absence of these skills, such problems are
viewed as threatening, stressful, and potentially unsolvable. Based on
the individual’s observation of both family members’ and peers’
responses to similar situations and from their own initial experimental
use of alcohol or drugs, the individual uses substances as a means of
trying to deal with these problems and the emotional reactions they
create. From this perspective, substance abuse is viewed as a learned
behavior cbt interventions for substance abuse having functional utility for the individual–the individual
uses substances in response to problematic situations as an attempt to
cope in the absence of more appropriate behavioral, cognitive, and
emotional coping skills. A number of substance abuse treatment strategies have derived from operant
learning principles. While they are often incorporated into broad-spectrum
cognitive-behavioral approaches, they have also been used as independent forms
of treatment.

the cognitive behavioral approach to therapy stresses

These clients may believe that they are hopeless
addicts and failures, that they will never be able to achieve and maintain
sobriety, and that there is no use in trying to change because they think
that they cannot succeed. Behavioral contracting and contingency management are often found as elements
in a number of more comprehensive approaches such as community reinforcement
and behavioral self-control training. One recent study evaluated the effects of a voucher program in the treatment
of methadone-maintained opiate addicts with a history of cocaine use (Silverman et al., 1998).

What are the pros and cons of cognitive behavioral therapy (CBT)?

Of course, Bandura’s self-efficacy and Erikson’s self-identity show many different features. However, it cannot be denied that, from the 1970s onwards, the self was a landing place where scholars with backgrounds as different as Bandura, Erikson, Kohut, and Rogers, found a meeting spot in which their theoretical distances significantly decreased. The self was a good alternative to the lost explicative power of concepts like Freudian drive or Beckian beliefs. However, it is apparent that over time in cognitive science emerged a “schema theory” focused on self-centered mental variables which play a mediating role. This phenomenon dates back to the publication of models by Neisser (1967) and especially by Markus (1977).

Common mindfulness-based interventions include manualized group skills training programs called mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (11). MBSR involves eight, 2–2.5-hour sessions with an instructor, in conjunction with a daylong retreat, weekly homework assignments, and practice sessions. Modules are designed to train participants in mindful meditation, interpersonal communication, sustained attention, and recognition of automatic stress reactivity. Mindfulness-based cognitive therapy has a structure similar to MBSR but includes cognitive therapy techniques to train participants to recognize and disengage from negative automatic thought patterns (12).

Steps in CBT

Individuals dependent on sedatives and tranquilizers or
heroin/opiates reported that negative physical states and interpersonal
conflict were the most important risk factors. Again, it is the individual’s
appraisal of such situations, in terms of its threat to maintaining
abstinence relative to their available coping abilities, that determines the
situational risk for the individual (Myers et al., 1996). While Ellis and Beck have similar views about the prominent role that cognitions
play in the development and maintenance of substance abuse disorders, their
theories differ in considering how the therapist should treat irrational or
maladaptive cognitions. Rational-emotive therapy is often more challenging and
confrontative, with the therapist informing the client of the irrationality of
certain types of beliefs that all people are prone to.

  • The skills to be taught are either specific to substance
    abuse (e.g., coping with craving, refusing an offer of alcohol or drugs) or
    apply to more general interpersonal and emotional areas (e.g., communication
    skills, coping with anger or depression).
  • These exposure techniques are similar in their function because they allow the patient to acquire new learning in order to modify the fear structure.
  • During cognitive behavioral therapy, a therapist can help you build and strengthen your goal-setting skills.
  • After the BAT, clients typically report on the severity of their anxiety and on any anxious thoughts that occurred during the exercise.
  • CBT focuses on present circumstances and emotions in real time, as opposed to childhood events.

Once the maladaptive thoughts are discovered in a person’s habitual, automatic
thinking, it becomes possible to modify them by substituting rational, realistic
ideas for the distorted ones to create a happier and healthier life without
substance abuse. CBT therapists emphasize what is going on in the person’s current life, rather than what has led up to their difficulties. A certain amount of information about one’s history is needed, but the focus is primarily on moving forward in time to develop more effective ways of coping with life. This might involve teaching you how to identify your goal or how to distinguish between short- and long-term goals.

Benefits of Cognitive Behavioral Therapy

An advantage of monitoring diaries is that they avoid problems of retrospective recall bias. Modern CBT has its roots in the 1950s and ’60s, when psychologists and psychiatrists working in South Africa, England, and the United States began to study the use of psychotherapeutic interventions based on principles of learning theory. Before long, behaviour therapy became an established form of treatment that included exposure-based strategies, techniques based on classical and operant conditioning, and other strategies aimed at directly changing problem behaviours. Overall, behavioral, cognitive, and cognitive-behavioral interventions are
effective, can be used with a wide range of substance abusers, and can be
conducted within the timeframe of brief therapies. Without such a thorough assessment, CBT treatment cannot proceed and is
likely to fail (Rotgers, 1996).

the cognitive behavioral approach to therapy stresses

CBT is also compatible with a number of other elements in
treatment and recovery, ranging from involvement in self-help groups to
pharmacotherapy (Carroll, 1998). Relapse prevention also stresses the development of a more balanced and
healthier lifestyle. Marlatt and Gordon posit that one source of possible
relapse risk has to do with the degree of stress or daily hassles that the
client experiences (Marlatt and Gordon,
1985). They suggest that when the demands and obligations a
client feels (“shoulds”) outweigh the pleasures the individual can engage in
(“wants”), then his life is out of balance.