Addiction: CBT for Reducing addiction

Question 1

What are the two parts of cognitive behaviour therapy?

Answer 1

• Cognitive functional analysis
• Behavioural skills training

Question 2

Explain cognitive functional analysis:

Answer 2

• Client and therapist work together to identify high-risk situations where the client is likely to gamble/take substance.
• They reflect on what the client would be thinking before, during and after the situation.
• The therapist then challenges the clients cognitive biases and must not accept them. They must have a strong relationship as the client is vulnerable and may find it difficult to open up.

Question 3

Explain cognitive restructuring within cognitive functional analysis:

Answer 3

• All CBT programmes aim to change a client’s addiction based cognitive biases.
• The biases are confronted and challenged by the therapist. There is an initial educational element, in which the therapist gives the client information about their addiction
• It is a gradual therapy. In the early phases it helps a client identify the triggers for their addiction. In the later phases it helps a client develop in circumstances they may struggle with and develop coping skills.

Question 4

Explain behavioural skills training for specific skills:

Answer 4

• CBT is a broad spectrum treatment as it focuses on wider aspects of a client’s life that are related to their addiction e.g. functional analysis may find that the client lacks skills that allow them to cope with situations where the substance/behaviour is available.
• Assertiveness training could be used to help a client confront interpersonal conflicts in a controlled and rational way instead of using maladaptive methods e.g. aggression, avoidance.
• Anger management can help some clients cope with the situations that make them angry enough to resort to drinking.

Question 5

Explain behavioural skills training for social skills:

Answer 5

• Most clients can benefit from learning skills that can help them cope in social situations. E.g. a recovering alcoholic will learn to cope in social situations where alcohol is available.
• Social skills training (SST) will help them learn to refuse alcohol sensibly e.g. making eye contact and politely decline a drink.
• The therapist may role play with the client in order to demonstrate to the client how to act in high-risk situations and may explain why this behaviour is being encouraged.

Question 6

What are the 4 evaluation points for cognitive behaviour therapy to treat addiction?

Answer 6

1) Relapse prevention (S)
2) Treats cognitions (S)
3) Short term only (L)
4) High drop-out rate (L)

Question 7

Explain relapse prevention (S) as an evaluation points for cognitive behaviour therapy to treat addiction:

Answer 7

• CBT is especially useful in preventing relapse
• CBT promotes a very realistic view of recovery and incorporates the likelihood of relapse into treatment.
• Relapse is viewed as an opportunity for further cognitive restructuring and learning rather than as a failure. It is an inevitable part of an addict’s life, but is manageable with improving psycho-social functioning.

Question 8

Explain treats cognitions (S) as an evaluation points for cognitive behaviour therapy to treat addiction:

Answer 8

• CBT addresses cognitions in order to improve how it interacts with our behaviour to successfully treat addictions.
• Behavioural interventions may work partially because of their effect on changing cognitions.
• E.g. when an alcohol addict has successfully reduced their alcohol intake they may say that they don’t actually need alcohol to cope- leading to further behavioural changes

Question 9

Explain short-term only (L) as an evaluation points for cognitive behaviour therapy to treat addiction:

Answer 9

• A limitation is that it may only be effective short-term.
• Cowlishaw conducted a meta-analysis of 11 studies comparing CBT for gambling addictions with control conditions.
• Showed that CBT had significant effects in reducing gambling behaviour for periods up to 3 months after treatment.
• However from 9 months after treatment, there were no significant differences in outcomes between the CBT and control group.
• The studies may have even overestimated the benefits of CBT because the studies were such poor quality.
• Suggests that CBT is useful for short-term use, but not sustainable long-term.

Question 10

Explain high drop-out rate (L) as an evaluation points for cognitive behaviour therapy to treat addiction:

Answer 10

• A limitation is that may addicted individuals drop out of CBT.
• Cuijpers found that drop-out rates in CBT treatment groups can be up to x5 greater than other forms of therapy- may be because CBT is emotionally demanding.
• Clients often seek CBT initially because a life crisis impacted by their addiction has driven them to therapy.
• Once the crisis is resolved or less significant, the clients will often give up on therapy.
• Suggests that the high drop-out rate is a major obstacle to success of CBT in reducing addiction.