Cognitive Behavioural Therapy

Question 1

CBT

Answer 1

• form of therapy which aims to change the distorted and faulty ways of thinking which lead people to use drugs or partaking in addictive behaviours
• the two elements of CBT are functional analysis and skills training
• functional analysis identifies the cognitive distortions leading to addiction and tackles them, replacing the thoughts with more adaptive ways of thinking
• skills training helps the client to develop coping mechanisms in order to avoid high-risk situations that usually trigger addiction-related behaviours

Question 2

Functional analysis

Answer 2

• firstly, the client and therapist work together to find out what high-risk situations make the client likely to gamble or use drugs
• the therapist will look at what the client is thinking before, during and after these situations and try to identify cognitive distortions
• a collaborative, responsive and warm relationship is desired between the client and therapist, which allows the therapist to challenge the distortions
• functional analysis goes on throughout treatment, helping to identify triggers in the early stages of therapy, figure out what they and why they take place

Question 3

Skills training

Answer 3

• skills training is introduced, starting off basic and becoming more specialised
• the first type of skills training is cognitive restructuring, which tackles biases that operate within the client below their level of awareness
• the faulty beliefs that the client holds are addressed, such as distorted interpretations of probability, randomness, gains and losses
• these faulty ideas and confronted and challenged by the therapist, who educates and addict and tells them why what they think is incorrect
• the second form of skills training is more focussed on specific skills
• assertiveness training is an example of this, which helps the client confront conflicts in a rational way rather Tham resulting to violence
• anger management can help clients, overcoming situations which make them feel angry enough to drink or gamble
• another type of skills training is developing skills to allow clients to cope with anxiety in social situations
• social skills training helps alcoholics for example, to refuse a drink with minimal fuss, avoiding unnecessary embarrassment
• the skill is introduced then practices through role play

Question 4

(+) EVAL - research support

Answer 4

• Petry et al. (2006) collected a sample of pathological gamblers for an experiment, in which they were randomly allocated into one of two groups
• the first group would got to gamblers anonymous and receive CBT, while the other group would just go to GA
• a year later they found that the CBT and GA gamblers gambled significantly less
• face-to-face contact was found to be more effective than working form a textbook
• there was a high level of control within this study, which means that its findings are strong evidence to suggest that CBT is effective for treating gambling addiction

Question 5

(-) EVAL - short term v. long term gains

Answer 5

• a number of studies do not show the same level of efficacy and Petry et al. (2006)
• Cowlishaw et al. (2012) looked at 11 studies comparing CBT with control conditions for treating gambling addiction
• the studies showed that in the short term, CBT had a medium to large beneficial effect for reducing gambling
• however, between 9-12 months later, there was no significant difference found between CBT and control group gambling habits
• this shows that in the long term CBT is not very effective
• Cowlishaw also concluded that many of the studies supporting CBT weren’t sound methodologically, therefore overestimating its efficacy

Question 6

(-) EVAL - lack of treatment adherence

Answer 6

• Cuijpers et al. (2008) found that drop-out rates for CBT were 5x greater than any other form of therapy
• this may have been due to its high demanding nature, as well as the time and money commitment
• some would not take CBT seriously, i.e. not doing the homework or attending sessions
• clients will start therapy due to a life crisis, but once it does not affect them as much, they will stop with the treatment before its completion
• this lack of adherence to the therapy makes it hard to understand the full effectiveness of CBT