Reducing addiction: CBT

Question 1

CBT for addiction

Reducing addiction: CBT

Answer 1

Aims to change maladaptive ways of thinking & behaving associated w/ substance or behavioural addictions
There are 2 elements to CBT programme
1. functional analysis; identifies cog biases that underlie addictions, replacing cog biases w/ more adaptive ways of thinking
2. Skills training; helps client develop coping behaviours to avoid high-risk situations that usually maintain addictions or trigger relapse

Question 2

Cognitive - Functional analysis

Reducing addiction: CBT

Answer 2

Starts w/ client & therapist together identifying high-risk situations in which client is likely to gamble or use a substance of addiction
Therapist reflects on what client is thinking before, during & after such a situation
Quality of client-therapist relationship is therefore critical
Should be warm, collaborative & responsive, but not cosy
Therapist must challange client’s biased cognitions & not merely accept them

Question 3

Functional analysis: Cog restructuring

Reducing addiction: CBT

Answer 3

In gambling add, restructuring addresses client’s faulty beliefs about probability, randomness, control, gains & losses
These are confronted & challenged by therapist
There is initial educational element in which therapist might give client info about nature of chance
Functional analysis is ongoing process
In early phases of therapy it helps a client identify the triggers for their addiction, a necessary starting point
It is useful later as well, in helping client to work out the circumstances in which tthey are having problems w/ coping & what further skills training may be needed

Question 4

Behavioural - Skills training

Reducing addiction: CBT

Answer 4

Most people who seek therapy for add usually have huge range of problems but only one way of coping w/ them - their add
CBT helps client replace this strategy w/ more constructive ones
CBT is flexible therapy so therapist will be able to call upon wide range if skills training, techniques, starting w/ basics & moving on to move individually tailored methods such as social skills training

Question 5

Skills training: Specific skills

Reducing addiction: CBT

Answer 5

CBT is broad-spectrum treatment as it focuses on wider aspects of client’s life that are related to their add
E.g. functional analysis may reveal that a client lacks specific skills to allow them to cope w/ situations that trigger alcohol use
Assertiveness training could be used to help client confront interpersonal conflicts in controlled & rational way instead of using avoidance, manipulation or aggression
Anger management training can help some clients cope w/ situations that make them angry enough to resort to drinking

Question 6

Skills training: Social skills

Reducing addiction: CBT

Answer 6

Clients benefit from learning skills that help them cope w/ social situations
E.g. a recovering alcoholic will find themselves in situations where alcohol is available
SST helps them learn how to refuse alcohol w/ minimum fuss & avoiding embarrassment (i.e. making appropriate eye contact & being firm in refusing an offer of a drink)
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