Reducing addiction: Cognitive Behavioural Therapy

CBT aims to change the faulty ways of thinking that lead to drugs or certain behaviours as maladptive ways of coping. 

1) CBT identifies and tackles cognitive distortions that underlie addictions, replacing them with more adaptive ways (functional analysis). 

2) Skills training helps the client to develop coping behaviours to avoid the high risk situations that usually trigger the behaviour. 

The client and therapist work together to identify high-risk situations.

The therapist reflects on what the client is thinking before, during and after such situations. 

It is an on-going occurrence. 

It can identify the triggers and the reasons for the addictive behaviours.

It can help the client work out whether they are still having problems with coping.

It can also help to identify what skills training may be needed.

It helps to reduce the coping strategy of and the dependence of drugs with more constructive strategies. 

1) Cognitive restructuring:

Tackles the biases.

2) Specific skills:

If in functional analysis the therapist identifies lack of skills to cope. 

Assertiveness training and anger management training are examples of this.

3) Social skills:

Helps the patient to cope in social situations.

SST (social skills training) teaches them how to refuse alcohol in social situations with minimal fuss and avoiding embarassment.  

1) Explanation of reasoning behind learning the behaviour.

2) Therapist explains how to perform the skill.

3) The client models the behaviour/ skill.

4) The client uses these skills in their own high-risk situations. 

1) Research support:

- Petry et al. recruited pathological gamblers through media advertising.

- They were randomly allocated into a control group (Gamblers Anonymous meetings) or the treatment group (CBT).

- The treatment clients were less-likely to gamble up to 12 months afterwards.

2) Relapse prevention:

- Clients who stuck with CBT are less likely to relapse.

- This is because CBT incorporates the likelihood of relapse and sees it as a chance for further cognitive restructuring.

- Whilst relapse is seen as an inevitable part of an addict's life, it is acceptable is their functioning improves.  

Short-term vs. long-term gains:

- Cowlishaw et al. reviwed 11 studies comparing CBT for gambling addiction with control group.

- Whilst CBT proved to have medium to very large benefits up to 3 months after treatment, this was not the case for 9-12 months afterwards.

- Cowlishaw therefore said that "the durability of therapeutic gain is unknown".