Reducing addiction - CBT Flashcards
What is Cognitive behaviour therapy
Based on the assumption that addictive behaviours are maintained by the person’s thoughts about the behaviours.
The ‘cognitive’ aspect of this therapy alters the way ppl think about their addictive behaviour
The ‘behavioural’ aspect helps them learn new ways of coping effectively with the circumstances
that led to these behaviours
How does CBT work?
Abt 10 1hr sessions.
They focus on how the individual thinks/feels when they engage in a particular behaviour and helps them develop more helpful ways of thinking and behaving
What is functional analysis in CBT?
CBT starts with the client and therapist identifying the high-risk situations where the client is likely to engage in the addictive behaviour
- therapist reflects on what client is thinking before, during and after such a situation. Quality of the client therapist relationship is critical, should be warm, collaborative and responsive.
How is functional analysis effective in the early phases of treatment?
helps the client identify the triggers/reasons for their addiction, which is a necessary starting point.
How is functional analysis effective in the later phases of treatment?
helps the client to work out the circumstances in which s/he is still having problems with coping and what further skills training may be needed.
What is cognitive restructuring in CBT?
tackles the biases that
operate even below the client’s level of awareness
e.g, In gambling addiction, training
addresses the client’s faulty beliefs about probability, gains and losses etc.
These are** confronted and challenged by the therapist**. There’s also an initial educational
element where the therapist gives the client information about the nature of chance.
How does CBT change behaviour?
After cognitive restructuring, where the individual begins to think differently about their behaviour, they are encouraged to practise these changes in their daily life
e.g: Gamblers may be asked to visit a casino and refrain from betting.
Internet addicts may be asked to avoid going online for 6 hours, then 12 hours and so on.
- During this time clients are encouraged to keep a diary to record the triggers related to
their addictive behaviour and to record their progress in overcoming their addiction.
How is skills training used in CBT
Therapist explains the reasoning behind learning the skill.
Perhaps, a lack of that skill was identified in the
functional analysis as the reason why they relapsed.
Therapist explains how skill is performed, but crucially models the behaviour which the client then imitates in
role play
What are skills used in skill training
- assertiveness training
- anger management
- social skills training
What is assertiveness training?
Helps the client confront interpersonal conflicts in a controlled and rational way instead of using avoidance, manipulation or aggression.
What is anger management?
training that can help some clients cope with the situations that make them angry enough to resort to drinking.
What is social skills training?
Allow them to cope
with anxiety in social situations.
E.g, training helps clients to learn how to refuse
alcohol with minimum fuss in ways that avoid embarrassment, such as making appropriate eye contact and being firm in refusing the offer of a drink.
How is relapse prevention used in CBT?
involves learning to identify and avoid risky situations that can
trigger feelings or thoughts that lead to relapse.
E.g, in the treatment of gambling addiction, clients learn to identify places (casinos, betting shops) feelings ( boredom, stress) and other difficulties (finances, work) that might prompt gambling behaviour.
What are strengths of CBT in reducing addiction
- Effective at treating relapse
- No side effects
What are limitations of CBT in reducing addiction
- Lack of treatment adherence
- Overemphasises irrational thinking
Evaluate the effectiveness of treating relapse as a strength of CBT
P: CBT appears to be especially effective at preventing relapse.
E: Most people’s experience of addictions is one of chronic relapse. CBT incorporates the likelihood of relapse into treatment, viewing it as an opportunity for further cognitive restructuring and
learning rather than as failure. Relapse may even realistically be seen as an inevitable part of the addict’s life, but acceptable as long their psychosocial functioning improves.
E: This is a strength of CBT as it could be considered a long-term treatment for certain individuals.
Evaluate no side effects as as strength of CBT
P: no side effects.
E: Treatment simply aims to treat the individual’s faulty thinking patterns and develop coping strategies so there cannot be any negative repercussions. The worst thing that can happen is that the person does not
respond well to the treatment and does not get better.
E: 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.
Evaluate lack of adherence as a limitation of CBT
P: Some may struggle to adhere to the treatment.
E: Drug/alcohol use alters thinking and perception and so these addicts may not be in the mindset to discuss their faulty cognitions. CBT maybe more effective for these addictions when used in combination with medication.
In a study of people with alcohol-related problems Feeney reported 14% abstention rates in
a group who had received CBT alone compared with 38% in a group who had received both CBT and
medication.
Cuijpers indicates that the drop-out rates in CBT treatment can be up to five times greater than other forms of therapy. May be because CBT is a demanding therapy. Even when the most high-risk users continue in treatment, they may take it less seriously, attending fewer sessions.
Clients often seek CBT initially because some life crisis caused by their addiction has driven them into therapy. Once the crisis is resolved, or diminished in importance, such clients often give up therapy.
E: Lack of treatment adherence is a major obstacle to a full understanding of how effective CBT is for reducing
addictions.
L: Therefore, the most effective treatment for addictive behaviour may be a multi-component programme.
Evaluate the overemphasis on irrational thinking as a limitation of CBT
P: There is an overemphasis on an individual’s irrational
thinking rather than acknowledging the stressful environment which may perpetuate their addictive behaviour.
E: These stressful environments (unhappy marriage or demanding job) exist beyond the therapeutic setting and
so continue to produce and reinforce addiction once the therapy has finished.
E: Suggests that CBT can be effective as a way of reducing addiction, but only as part of a wider form of intervention
that also addresses the social environment in which addiction occurs.
