What is Cognitive Behavioral Therapy?
Cognitive Behavioral Therapy (CBT) is a popular form of psychotherapy, or “talk therapy.” During CBT, clients meet with a trained therapist in a safe, confidential environment to explore their feelings and behaviors in order to develop effective coping skills. According to the National Alliance on Mental Illness, the therapist leads the conversation during these psychotherapy sessions and touches on certain topics designed to get clients to examine their own thoughts and behaviors, as well as how they might have led to drug addiction.
The Relationship between Thoughts, Feelings, and Behaviors
During Cognitive Behavioral Therapy, clients explore the relationship between their thoughts, feelings, and behaviors. Therapists administering CBT actively work to uncover an individual’s unhealthy thought patterns so together they can identify how those particular patterns result in self-destructive behaviors. Once the negative thought patterns have been identified, clients can then focus on developing more constructive ways of thinking and engaging in productive behaviors stemming from more optimistic beliefs.
CBT works by identifying false or negative beliefs and restructuring or testing them to produce positive results. Therapists who administer Cognitive Behavioral Therapy often give their clients homework assignments, which are exercises that they can work on in between sessions. These exercises usually consist of replacing negative thoughts with more positive ones based on prior successes. Individuals may also be told to record their destructive thoughts in a journal.
Treating Substance Use Disorders
According to the National Institute on Mental Health, Cognitive Behavioral Therapy can be adapted to treat a variety of mental health disorders, including:
- Bipolar disorder
- Various eating disorders
CBT is also a popular form of therapy used in rehabilitation programs to treat people who are struggling with addiction. In fact, according to the National Institute on Drug Abuse, it was initially developed to prevent relapse in individuals who were in recovery from alcohol abuse. Therapists adapted it to treat clients who were addicted to cocaine, and now it is used to treat many different mental health disorders. A study on psychosocial treatments for cocaine dependence originally published in Psychiatric Clinics of North America found that 60 percent of subjects who underwent CBT produced clean toxicology reports at their follow-up appointment one year later.
Clients in CBT learn how to anticipate potential problems while developing the coping skills needed to confront them if they do arise. When CBT is used to treat a substance use disorder, clients explore the consequences of regular drug use and practice identifying and avoiding situations that might put them at risk for using again.
Clients with co-occurring disorders may benefit significantly from Cognitive Behavioral Therapy. According to a study originally published in Addictive Behaviors, 35-50 percent of people enrolled in treatment programs for addiction have a lifetime diagnosis of PTSD, and 25-42 percent have a current diagnosis. In that study, researchers found that subjects suffering from a substance use disorder and PTSD had a positive outcome when they underwent Cognitive Behavioral Therapy. Because CBT does not focus on combatting addiction directly but rather on combatting negative thought patterns that contributed to addiction, it can be an effective way to treat a variety of mental health disorders that occur alongside the disease.
It is important to remember that though many clients find success using Cognitive Behavioral Therapy, it is just one treatment modality, and it does not work for everyone. Individuals who are especially sensitive or emotional and expect to build a strong rapport with their therapist may not get the results they want from CBT.
CBT focuses on dysfunctional thoughts and may not focus on the person as a whole as much as a client wishes. In addition, Cognitive Behavioral Therapy may not be effective for people with certain learning disabilities.
Benefits of Enrolling in CBT
There are countless ways to treat addiction, as well as the other mental health disorders. Many people rely on a variety of treatments to enter and stay in recovery, and there are several benefits of using CBT as one of those methods. Cognitive Behavioral Therapy is:
- Short-term: Recovery programs can take months or even years to be truly effective, but CBT has a specific point at which formal therapy ends. It is a time-limited approach that gives clients a clear view of how long their treatment is going to last.
- Effective: According to the American Psychological Association, CBT can help clients overcome addiction by teaching them how to change the destructive thoughts and behaviors that resulted in substance abuse. CBT has proven to be especially effective when combined with other treatment modalities.
- Structured: Every session of CBT has a specific agenda, and clients learn to expect the techniques they will be using in each meeting. CBT is a structured way for individuals to establish and pursue tangible goals for life after addiction.
- Collaborative: CBT requires active participation from both the therapist and the client. Once clients reveal what they want to change, the therapist can help them determine how to go about actually making those positive adjustments in their lives.
- Flexible: Flexibility is a key component of CBT, and even clients enrolled in outpatient programs who don’t attend sessions frequently can benefit from the flexibility that it offers.
- Positive: Clients in Cognitive Behavioral Therapy learn to approach life in a more optimistic way, which leads them to have more positive, productive experiences in general.
Administering Cognitive Behavioral Therapy
There are a number of mental health professionals who can administer Cognitive Behavioral Therapy. The most competent therapists typically receive training in a variety of disciplines but focus on CBT extensively at some point. Professionals who can administer Cognitive Behavioral Therapy include:
- Psychologists: Psychologists are individuals who have doctoral degrees from graduate programs that are approved by the American Psychological Association. Clinical psychologists must complete a one-year internship in a clinical setting, as well as two years of supervised experience, in order to receive their license.
- Psychiatrists: Psychiatrists must have a medical degree, and they must have completed a medical internship. Many psychiatrists complete their training with a five-year residency program.
- Clinical social workers: Clinical social workers must have a college degree in addition to two years of training in an accredited graduate program. Certified social workers have a master’s or doctoral degree in social work from an accredited program, as well as two years of experience. Licensing requirements vary by state.
- Professional counselors: Professional counselors usually have a doctoral, specialist, or master’s degree from an accredited university.
Like all types of therapy, Cognitive Behavioral Therapy works better for some clients than it does for others. Estimates of its efficacy vary among researchers, but according to Great Britain’s Center for Economic Performance, CBT has a 50 percent success rate for clients suffering from a mental illness.
Cognitive Behavioral Therapy is a short-term therapy, but the precise timeline varies among individuals. Clients typically attend anywhere from 10 to 20 sessions with their therapist. Factors that affect the duration of treatment include:
- The severity of cravings and other withdrawal symptoms
- How long the substance abuse has been occurring
- How quickly the client makes progress
- How much stress the client is experiencing while in therapy
- How much support the client has from friends and family
Many insurance plans cover Cognitive Behavioral Therapy, but some do not. If clients receive CBT in a rehab setting, it may be covered in the cost of the program. CBT is just one of many ways to treat substance abuse and prevent relapse, but for many people, it is an effective approach that leads to more positive changes down the road.
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