Addiction - treating addiction (CBT) Flashcards
What is the basic assumption of Cognitive Behavioural Therapy (CBT) for addiction?
CBT is based on the assumption that addictive behaviours are maintained by the individual’s thoughts about these behaviours. The ‘cognitive’ aspect changes how individuals think about their addictive behaviour, while the ‘behavioural’ aspect helps them learn new ways of coping with past triggers.
How does Cognitive Behavioural Therapy (CBT) typically work?
CBT typically involves around 10 one-hour sessions, focusing on how the individual thinks and feels when engaging in addictive behaviour. It helps them develop more helpful ways of thinking and behaving.
What is “functional analysis” in CBT for addiction?
Functional analysis in CBT involves identifying high-risk situations in which the client is likely to engage in addictive behaviour (e.g., gambling, drinking, or drug use). The therapist reflects on what the client is thinking before, during, and after such situations. It’s an ongoing process that helps the client identify triggers and later refine coping skills.
Why is the client-therapist relationship important in CBT for addiction?
The client-therapist relationship in CBT should be warm, collaborative, and responsive but not too cozy. The therapist must challenge the client’s distorted cognitions, not merely accept them.
What is cognitive restructuring in CBT for addiction?
Cognitive restructuring in CBT addresses cognitive biases that individuals may not be aware of, such as faulty beliefs about probability, randomness, control, and gains/losses. The therapist confronts and challenges these beliefs to change the way the client thinks about their addiction.
How does CBT help individuals change their behaviour after cognitive restructuring?
After cognitive restructuring, individuals are encouraged to practice the new ways of thinking and behaving in real life. For example, gamblers might visit a casino without betting, and internet addicts might gradually avoid going online for increasing periods.
What role does diary-keeping play in CBT for addiction?
In CBT, clients are encouraged to keep a diary to record the triggers related to their addictive behaviour and their progress in overcoming it. This helps track their journey and identify problem areas.
What is skills training in CBT, and how does it help individuals with addiction?
Skills training in CBT teaches clients new skills, such as assertiveness, anger management, and social skills, to cope with situations that trigger their addiction. It helps clients avoid maladaptive behaviours like avoidance or aggression and equips them to deal with high-risk situations.
What is the role of relapse prevention in CBT for addiction?
Relapse prevention in CBT teaches clients to identify and avoid risky situations that may trigger thoughts or feelings leading to relapse. For example, in gambling addiction, clients learn to recognize high-risk places (e.g., casinos) or emotional triggers (e.g., boredom, stress) that could prompt gambling behaviour.
Why might CBT not be effective for all addicts?
Drug and alcohol use can alter thinking and perception, making it difficult for addicts to engage with CBT. Addicts may struggle to reflect on faulty cognitions, especially during early stages of recovery.
What does research by Feeney (2002) suggest about CBT and medication?
Feeney (2002) found higher abstention rates in alcohol addicts who received both CBT and medication (38%) compared to CBT alone (14%), suggesting a combined approach is more effective.
What did Cuijpers et al. (2008) find about CBT?
Dropout rates for CBT can be up to 5x higher than for other therapies. This may be due to the demanding nature of CBT, with some clients losing motivation once a life crisis is resolved. High dropout rates reduce our understanding of how effective CBT really is. Those who leave early may skew results, making it hard to assess true long-term success.
What is a key advantage of CBT compared to biological treatments?
CBT has no physical side effects. It focuses on altering thought patterns and behaviour, meaning clients won’t develop additional problems like those sometimes caused by medications. This is a strength of CBT as it means that the individual will not acquire other maladaptive behaviours as a result of the treatment and it therefore might be more effective than biological treatments or aversion therapy.
What is a criticism of CBT’s individual focus?
CBT may overemphasize irrational thinking and neglect external stressors (e.g. difficult relationships or job stress), which can continue to fuel addiction after therapy ends.
How can CBT’s effectiveness be improved?
By combining it with interventions that target the client’s environment, such as family therapy, social support, or workplace changes, CBT can become more holistic and impactful.
What is a strength of CBT as a treatment of addiction?
CBT teaches coping strategies and anticipates relapse, it helps addicts handle setbacks without completely reverting to old habits. This builds resilience over time, which means that CBT has long term implications for treating addiction.
