COGNITIVE BEHAVIORAL THERAPY
Cognitive behavioral therapy (CBT) is a commonly used type of talk therapy for a wide-variety of mental health and psychological disorders, including drug and alcohol addiction and dual diagnosis disorders. CBT is also effective to learn how to better manage life stressors and is not necessarily used only for diagnosable illnesses.
The underlying theme of using cognitive behavioral therapy is reframing. In reframing, the patient will learn how to nonjudgmentally evaluate his/her line of thinking and to change inaccurate or negative thoughts. The line of thinking affects emotions, which in-turn affect behaviors. This is a highly-valuable tool for the treatment of drug addiction and alcoholism, as this subset of patients typically has an immensely distorted perception of themselves and others. CBT is also used to confront defense mechanisms, such as denial, rationalization, denial, and avoidance.
Cognitive behavioral therapy for substance abuse believes that the behavior that causes emotional or external consequences doesn’t come from activating events or environmental events, but occurs due to the patient’s line of thinking and emotional reactions. Thus, the primary thing that must be changed is the drug addict and alcoholic’s way of viewing themselves and the world. For example, if one is late to work, they may tell themselves that they will get fired, that they are a poor co-worker and that they are not important. In reality, they may be a decent worker and are valued by the company. Instead, healthy negative emotions may be frustration or sadness, which can lead to changing one’s behavior to prevent the consequences in the future. Catastrophic thinking and irrational assumptions about the world that can cause one who suffers from drug addiction and alcoholism to use substances to alter their mood or avoid the situation, particularly the intense negative emotions, such as depression, worthlessness, hopelessness, anxiety, and especially anger.
The psychologist Aaron Beck believed that intense negative thoughts are automatic and persist even though there is ample evidence that contradicts these thoughts, and developed a schema for therapy that is called the, “Cognitive Triad.” In this form of therapy, it is believed that there is a cycle that repeats itself and included negative views of oneself, the future, and the world. These views work together to create depression, and lead to behaviors that cause negative consequences.
A schema is how one thinks of themselves and the world. Schemas can somewhat predict one’s emotions and reactions to events and are thought to arise from childhood, or other events that have occurred in one’s life. Schema based cognitive therapy has become a valuable type of therapy for substance abusers, because it forces the patient to take a thorough evaluation of oneself in the safe setting of a drug and alcohol rehab. The patient’s schema leads to the formation of a unique set of defense mechanisms such as denial, avoidance, defensiveness, etc. The set of defense mechanisms that are commonly utilized is specific to each patient. These defense mechanisms prevent a person from exhibiting positive behaviors in response to an event.
Within the modality of cognitive behavioral therapy, there are several different subsets of counseling that exist. Therapeutic modalities such as rational emotive behavior therapy (REBT), dialectic behavior therapy (DBT), schema-based cognitive therapy, exposure therapy, and mindfulness-based therapy are all types of CBT. The modality chosen with any give patient will be determined by the treatment staff at the drug and alcohol rehab. Certain patients and disorders respond differently to different modalities of treatment.
It has recently been discovered that physical changes in brain structure and chemistry after undergoing cognitive behavioral therapy are similar to those achieved by certain psychiatric medications, such as antidepressants. It is important to note that when receiving treatment for drug addiction and alcoholism and dual diagnosis disorders, prescribed psychoactive medications work best when given within the setting of an appropriately formulated counseling plan.
Because CBT explores uncomfortable feelings which can be triggering, it is best when initially performed in a drug or alcohol rehab. As the patient progresses, a progressive stepdown to less restrictive levels of care will be recommended. It is important that the patient have a relapse prevention plan for the feelings that arise during a CBT session. Cognitive behavioral therapy should be performed by an experienced therapist who has the support of psychiatrists to assist in any mental health issues that may be treatable using medications.
The licensed therapists at Behavioral Wellness and Recovery are specifically trained in various types of CBT and will work to ensure that you or your loved one will receive the best possible drug and alcohol rehab experience possible. Should you require assistance or would like your questions answered, our Addiction Specialists are available 24/7 at 800-683-4457.
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