Reducing addiction- Cognitive Behavioural Therapy Flashcards
What is CBT?
- Method for treating mental disorders based on cognitive and behavioural techniques
What is the aim of cognitive behavioural therapy for addiction?
- Aims to change maladaptive ways of thinking/behaviour associated with substance/behavioural addictions
What are the 2 cognitive aspects of CBT?
1) Functional analysis
2) Cognitive restructuring
What are the 3 behavioural aspects of CBT?
1) Specific skills training
2) Social skills (training)
3) Practice
What is functional analysis?
- Client and therapist identify high-risk situations (more likely to gamble/ smoke)
- Therapist reflects on client’s thoughts before, during, after a situation
- Quality of relationship= warm, collaborative, responsive NOT cosy
What is cognitive restructuring?
- Address faulty beliefs about addiction- aim to change addiction-related cognitive biases
- Educational element- client given info about nature of chance
- Ongoing process- identify triggers, work out circumstances in which they struggle to cope, and what skill training is needed
What is specific skills training?
- Specific to clients needs (e.g: anger management, assertiveness training) to provide coping skills in triggering situations
- Most have a range of problems but only one coping mechanims= addiction
- CBT helps replace strategy with constructive ones
- Flexible so wide range of skills training techniques
What are the types of specific skill in CBT?
- Assertiveness training: helps clients confront interpersonal conflicts in a controlled/rational way, instead of avoidance, manipulation, aggression
- Anger management: helps clients cope with situations that make them angry enought to resort to drinking
What is social skills training?
- Explain reasons for needing social skills and how they can help
- Modelling and role play to practice
- Highlt directive- ‘show and tell’
- SST: help learn to refuse alcohol with min fuss (avoid embarassment)
Limitation-
I- Only effective in short term
D- Cowlishaw et al conducted meta-analysis of 11 CBT vs control studies for gambling addiction. CBT= medium to very large effects for up to 3 months post-treatment. After 9-12 months, no significant difference between groups
E- Overestimated benefits- short term but long term disappointment
Strength-
I- Research support
D- Petry et al randomly allocated pathological gamblers to gamblers anonymous (GA) group or GA and 8 CBT session group. Treatment (B) gambled significantly less 12 months later
E- Findings suggest CBT is effective in reducing long term addiction (high internal validity)
Limitation-
I- High drop out rates
D- Cuijpers et al- drop out rates up to 5x greater than for other therapies. May be because CBT is demanding. Clients often seek CBT as a life crisis caused by their addiction has driven them into therapy- but once crisis is resolved, therapy stops
E- Major obstacle to success of CBT- limited
Strength-
I- Useful in preventing relapse
D- CBT presents realistic view of recovery and incorporates likelihood of relapse in treatment. Relapse- opportunity for further cognitive restructuring and learing NOT as a failure. An inevitable part of an addict’s life, but manageable as long as psych functioning improves
E-When clients stick with therapy, CBT helps avoid relapse by maintaining a stable lifestyle
Evaluation extra-
I- Is the cognitive aspect relevant?
Strength- targets both cognitions and behaviours. Behavioural interventions work due to their effect on changing cognitions. This leads to further behavioural change and prevents risk of symptom substitution
Limitation- could treat addiction if only focused on behaviour. Covert sensitisation does not address cognitions, which raises the question of whether CBT needs to. Changing cognitions may be counterproductive as it is the most demanding aspect
E- CBT should address cognitions as they interact with behaviour, so the 2 affect each other to reduce addiction
