Reducing addiction: CBT AD

Question 1

Cognitive behaviour therapy CBT

Answer 1

A method for treating mental disorders based on both cognitive and behavioural techniques

Question 2

CBT aims to change the maladaptive behaviours and ways of thinking associated with addictions. There are 2 elements to CBT:

Answer 2

Functional analysis
Skills training

Question 3

functional analysis

Answer 3

CBT starts with a client and therapist together identifying the high risk situations where the client is likely to give in to their addiction. The therapist reflects on what the client is thinking before, during and after one of these situations. The quality of the client-therapist relationship is crucial. The therapist must challenge the biassed thinking and not accept them.

Question 4

cognitive restructuring

Answer 4

In gambling, restructuring addresses the clients faulty beliefs about gambling related things. The therapist confronts and challenges them. There is an initial education element, where the therapist might give the client information about the nature of chance.

Question 5

Describe functional analysis’ ongoing process

Answer 5

In early stages of therapy it might help a client identify the triggers for their addiction. In later stages of therapy it might help to work out the circumstances in which the addict is still having problems.

Question 6

skills training

Answer 6

Most therapy seeking people have many problems, which their addiction helps them to cope with. CBT helps the client replace this with more functional strategies such as skills training techniques.

Question 7

Specific skills training

Answer 7

Specific to the clients needs e.g. anger management or assertiveness training to provide coping skills in triggering situations

Question 8

Social Skills

Answer 8

Identify wider needs - What do you need to be able to do? How to cope when offered opportunities to engage with addiction

Question 9

Social Skills Training

Answer 9

Explain reasons for needing the skill and how they can help
Modelling & role play to practise skills
Directive - show and tell

Question 10

Practice

Answer 10

Using the skills on own in high risk situations

Question 11

short term only

limitation

Answer 11

• Cowlinshaw et al conducted meta analysis of 11 studies
• CBT had medium to large effects in reducing gambling behaviour for a period of up to 3 months after treatment
• But for 9-12 months there was no significant change
• Studies may have overestimated the benefits of CBT
  The research for CBT is one of short-term benefit

Question 12

counterpoint to short term only

strength

Answer 12

• Some high quality research that challenges this
• Petry et al randomly allocated pathological gamblers to either a control or treatment group
• The treatment clients were significantly less likely to gamble
• Study had high internal validity because of the random allocation
  This singular study suggests that CBT is effective in reducing gambling addiction beyond short term

Question 13

relapse prevention

strength

Answer 13

• Addiction is often a repeated relapse
• CBT presents a realistic view of recovery and incorporates the likelihood of relapse into treatment
• Relapse is viewed as an opportunity for cognitive restructuring rather than as a failure
  When clients stick with the therapy, it can help them to avoid relapse by maintaining a stable lifestyle

Question 14

high drop out

limitation

Answer 14

• Cuijpers et al found that drop outs are 5X more likely in CBT then other treatments
• CBT is very demanding
• Clients often seek CBT for a crisis that drove them to drink so when the crisis is over they stop going
  Major obstacle to success of CBT in reducing addictions