Cognitive behavioral therapy to treat drug addiction

Substance misuse is an ever-changing topic that necessitates extensive examination and analysis to discover the best strategies to treat the problem. New substances and ideas continue to arise in society as the social, economic, and technological components evolve and develop. As a result, academics and psychologists have focused time and resources to understanding some of the effects and mechanisms of substance abuse management. According to research, substance abuse is a multifaceted disorder (McHugh, Hearon & Otto 511). The form is distinguished by a pattern of maladaptive use of a psychoactive substance that has been associated to significant disability and distress.  Over the past half-century, there has been significant comprehension of the substance abuse patterns in the medical field as evident by the development of the pharmacological and psychosocial treatments (McHugh, Hearon & Otto 511). Health professionals sought to create ways that are cost-effective and efficacy in addressing substance abuse problems in the society. There has been an increase in the illegal drugs consumption in the United States (U.S.) and across the world due to the ineffective legislation and globalization. Treating a substance abuser is hard. One must strive to go beyond the outcome of the substance on the person to understand how they deal with the drug, factors that lead them to abuse drugs, and the role of the drug on their lives. Cognitive Behavioral Therapy (CBT) provides an adequate platform or perspective for understanding substance abuse problem in an individual. Thus, there is need to examine CBT as a treatment method for reducing substance abuse issue while discussing the behavioral and psychological impacts of the approach.

CBT views the substance abuse as a learned behavior which is acquired by a person through experience. For instance, a stressed individual who yearns for a good feeling and reduced stress or tension, they will most likely take the drugs with the motive of achieving the outcome (Rangé & Mathias). In most cases, people who abuse drugs do not have any means or approach to addressing the issue. Substance abuse provides the only viable alternative for managing their problems. From this perspective, it is clear that CBT is centered on the identification of the specific needs that the substance is being used by a person to meet and develop some of the skills that will offer alternative ways of addressing those wants and needs (McHugh, Hearon & Otto 512). CBT ensures that a person is aware of their problem and understand ways in which it affects their daily functioning. As a result, it is easy for an individual to create a healthy way of life.

The effectiveness of the CBT depends on the correct diagnostic criteria. It is pivotal to understand if a person is suffering from either substance abuse or substance dependence. However, this case will focus on substance abuse which is characterized by a heavy use of drugs. An individual continues to use the substance even if it impairs their social, family and physical and occupational aspects. According to Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), substance abuse is monitored yearly (Rangé & Mathias). A person should fail to fulfill their primary roles at home and work. The recurrent substance abuse should lead to legal, social, and interpersonal problems (Rangé & Mathias). CBT would ensure that the correct approach is employed in addressing the issue. In most cases, the treatment providers fail to ascertain whether a person suffers from substance abuse or dependence due to lack of proper diagnostic criteria (Rangé & Mathias). In the long run, a person will tend to be treated for the wrong conditions leading to the persistent of the problem.

CBT employs different approaches in treating an individual portraying substance abuse problem. For instance, ‘behavioral’ technique focuses on the visible antecedents and related consequences of their behavior (Rangé & Mathias). In this case, there is no making reference to the internal actions which can only be known through self-report. On the other hand, ‘cognitive-behavioral’ approach centers on the emotions, cognitions, and thoughts among other aspects that tend to maintain or precipitate a given behavior. However, the current methods employ behavioral means such as reinforcement and repeated practice to inform the substance abuse patients (Rangé & Mathias). CBT incorporates certain types of learning namely by association and consequences. Learning by association is whereby substance use triggers neutral stimuli. The repeated association will strengthen the addiction. In most cases, the triggers are external to the person such as certain people, locations, and environment (Kadden). Internal events may be aspects such as emotions and physiological changes. An individual learns to associate certain situations in their lives with the substance. Hence, the person will likely take the drugs as means of reminiscing the past events. On the other hand, learning by consequences involve behaviors that are strengthened by the outcome that usually follows from the substance use. Results may either be positive or negative reinforcement (Kadden). For instance, positive reinforcement is whereby after taking the substance a person feels aroused or euphoric is certain circumstances. Thus, they will tend to repeat the uptake in the future. Negative reinforcement is whereby a person abuses substance as means of reducing depression, anxiety, stress, and tension (Kadden). In this case, the goal is to terminate or reduce the unpleasant experiences.

CBT was established as an approach to stop relapse when treating patients exhibiting substance abuse. In the past, the caregivers failed to ascertain appropriate techniques for addressing substance abuse problem because people often relapsed after a thorough treatment procedure. CBT is centered on the idea that when people are developing maladaptive tendencies, the learning process plays an integral role (Rangé & Mathias). Hence, people with substance abuse problem should learn to recognize and address the problematic behaviors through the application of diverse skills as means of preventing the issue. The primary element of CBT involves the anticipation of the potential problems and boosting their self-control by assisting them in creating effective coping skills. A person has to explore consequences both positive and negative of substance abuse. The exploration will help in determining the situations that pre-exposes the individual and development of strategies that would be pivotal in the avoidance of high-risk circumstances (Rangé & Mathias). Psychological dependence can be employed in conceptualizing the importance of coping skills exercise. People exhibiting substance abuse problem have particular challenges or issues in their lives that could only be reduced or terminated through the use of the drugs (Kadden). The short-term and repeated experience of substance abuse will be likely to solve the problems. As a result, the person will start using the substances as a coping technique. In this case, the individual does not have any alternative coping strategy.

CBT has been designed such that the psychological and behavioral tendencies of the person exhibiting substance abuse problem is evaluated and analyzed. For instance, there is interviewing, cognitive therapy, and relapse prevention. Motivational interviewing has been structured to address the people who are resistant to behavioral changes (McHugh, Hearon & Otto 513). The interviewing of the individuals that portray substance abuse should acknowledge their autonomy by ensuring that they are committed and motivated to the treatment. A therapist should ensure that a sufficient relationship is developed as means of preventing conflicts (Kadden). The interviewing process helps in highlighting the feeling and emotions of the doubt. From this perspective, the therapist acknowledges that the person must go through specific stages for them to achieve the needed behavioral change (McHugh, Hearon & Otto 513). CBT recognizes that behavioral change is the responsibility of the patient and their respective performance. Thus, the therapist employing CBT should express compassion, cultivate inconsistency, shun quarrels, roll with confrontation, and promote self-efficacy.

Cognitive therapy focuses on the intermediate and core beliefs that are portrayed by individuals with substance abuse problem. For example, they have different perspectives on matters regarding hopelessness, lack of love, boredom, frustration, and helplessness (Rangé & Mathias). When an individual start substance use, there is the appearance of anticipatory beliefs. During the initial stages, the person may have statements such as ‘drinking creates a good feeling.’ However, as they develop gratification their statements start changing to declarations such as ‘drinking makes me merrier and cheerful.’ The changes are psychological. Thus, there is need to eliminate or reduce the stimuli that activate the beliefs and cravings. Cognitive therapy provides an adequate platform for introducing and reinforcing the adaptive beliefs (Rangé & Mathias). As a result, an individual facing substance abuse can realistically conduct themselves and thought on matters regarding their problem. The ability to restructure their thoughts and emotions allow subject to address the problem and situations that were once considered unbearable. CBT treatment of substance abuse offers its challenges during the process. The primary challenge arises from the inability to conquer the withdrawal symptoms of the drugs. Thus, the creation of contingency management helps in promoting the non-drug reinforce such as vouchers and prizes for abstinence from the substances (McHugh, Hearon & Otto 513). The lottery-type approach could be employed as a countermeasure to the withdrawal symptoms or effects.

Relapse prevention (RP) is the last and most crucial stage of the CBT, primarily on individuals with substance abuse. The primary objective of RP is to limit or prevent the incidence of the relapse grounded on the amalgamation of psychological and behavioral interventions (McHugh, Hearon & Otto 513). In this case, substance abuse is regarded as a maladaptive habit and hyper-learned. RP focuses on identifying and preventing high-risk situations which exposes a person to engage in the substance abuse. RP should evaluate and recognize the lifestyle of the individual before undertaking any step in preventing them from participating in their vices (Rangé & Mathias). There are various determinants of the addictive habit such as environmental and individual history, opinions and prospects, and past learning practices on drugs. RP has frameworks that review cases of relapse in high-risk situations (Rangé & Mathias). When a person relapse, they should be encouraged to identify the reasons and some of the possible alternatives to avoid in the future.

In conclusion, the process of dealing with people that have substance abuse problem is not gratifying. CBT provides a platform for efficiently addressing the needs and wants of individuals through the adequate identification and management of the condition. It is the responsibility of the therapist to ensure that the person is in charge of their change process. The therapist is only tasked with training, supporting and providing the much-needed feedback.

Works cited

Kadden, Ronald M. "Cognitive-behavior therapy for substance dependence: Coping skills training." Retrieved June 28 (2002): 2002.

McHugh, R. Kathryn, Bridget A. Hearon, and Michael W. Otto. "Cognitive behavioral therapy for substance use disorders." Psychiatric Clinics of North America 33.3 (2010): 511-525.

Rangé, Bernard P., and Ana Carolina Robbe Mathias. "Cognitive-Behavior Therapy for Substance Abuse." Standard and Innovative Strategies in Cognitive Behavior Therapy. InTech, 2012.