When clients limit their options for coping with stress
by rigid or all-or-nothing thinking (e.g., “nothing will help me deal with this
problem but a drink”), cognitive therapy can help them explore alternative
behaviors and attitudes that do not involve the use of substances. In addition,
cognitive therapy can help the client develop healthier ways of viewing both his
history of substance abuse and the meaning of a recent “slip” or relapse so that
it does not inevitably lead to more substance abuse. Near the end of the initial session the therapist reviews with the client
the procedure for filling out the self-monitoring records. In addition,
the therapist might provide the client with self-help manuals that
outline the specific steps in the behavioral self-control process.

The outpatient CBT program developed by Carroll for
cocaine users excluded a number of different clients as inappropriate for
that form of treatment (see Figure 4-21
). However, even though these criteria were derived from cocaine users, they
appear to be applicable to clients using other substances. The therapist in this case might consider using skills training that focuses
on problemsolving, stress management to alleviate his depression, developing
communication skills, practicing substance refusal skills, and developing a
social support network. The therapist should target both this client’s low
self-efficacy and his positive cocaine-effect expectancies.

Cognitive behavioural models of substance use

Whatever the origin of the deficits, a primary goal of CBT
is to help the individual develop and employ coping skills that effectively
deal with the demands of high-risk situations without having to resort to
substances as an alternative response. Questionnaires, interviews, and role-playing measures are available to assist
the therapist in the assessment and functional analysis. The therapist
should try to evaluate the number and type of high-risk situations, the
temptation cognitive behavioral interventions for substance abuse to use in these situations, confidence that one will not use in
high-risk situations, substance abuse-related self-efficacy, frequency and
effectiveness of coping, and substance-specific effect expectancies. More
detailed information on the assessment process in cognitive-behavioral
approaches to substance abuse and its treatment is available in a number of
sources (Donovan, 1998; Donovan and Marlatt, 1988; Monti et al., 1994; Sobell et al., 1988; and Sobell et al., 1994).

One of the distinguishing features of CBT has been its relative durability of effects, with significant treatment effects persisting through a follow-up period, in some cases with individuals showing greater improvement after treatment ends (i.e., ‘sleeper effect’) (e.g., Carroll et al., 2000; Carroll et al., 1994b; Rawson et al., 2002). There are many challenges that may arise in the treatment of substance use disorders that can serve as barriers to successful treatment. These include acute or chronic cognitive deficits, medical problems, social stressors, and lack of social resources. In addition, certain populations, such as pregnant women and incarcerated patients, may present particular challenges.

Aggression Replacement Training (ART)

The wife was involved in therapy, to support his abstinence and help him engage in alternate activities. Rajiv’s problem is an illustration of how various psychological, environmental and situational factors are involved in the acquisition and maintenance of substance use. This article will break down the clinical conditions that CBT addresses, how it helps those struggling with substance use disorders and other mental health https://ecosoberhouse.com/ conditions, and who this type of treatment might be right for. Similar limitations occurred in a Swiss study of an 8-module internet-based program encompassing CBT and MI called Snow Control for individuals reporting cocaine use at least 3 times in the past 30 days (Schaub, Sullivan, Haug, & Stark, 2012). Participants were randomly assigned to the Snow Control program or an 8-session online psychoeducation control.

Clients in the contingent voucher
condition, compared to those who received vouchers on a noncontingent basis,
reported decreased craving for cocaine and significantly increased cocaine
abstinence. A more general positive treatment effect was also noted, with
clients in the contingent voucher condition also demonstrating an increased
abstinence from opiates. According to behavioral theory, changes in behavior come about through learning
new behaviors.

Cognitive-Behavioral Interventions – Core Youth (CBI-CY)

Uptake of the computerized intervention was weak, with only 63% of those assigned to this condition accessing a module, and rates of 3-month follow-up were modest across conditions (57% of those in waitlist control and 48% of those assigned to computerized intervention). As standard outcomes (urinalyses or self-reported days of amphetamine use) were not reported, it was difficult to draw conclusions regarding the efficacy of the intervention in this sample. Several studies examined the effectiveness of CM as a supplement to traditional drug counseling. The studies initially provided relatively high rewards (as high as $1,000) for sustained abstinence from substance use [47-49], but recently, effectiveness studies have focused on providing low-cost CM as a more feasible addition to traditional counseling programs.

• Cognitive interventions can be introduced at any point throughout the
  treatment process, whenever the therapist feels it is important to examine a
  client’s inaccurate or unproductive thinking that may lead to the risk of
  substance abuse.
• As is the case for other evidence-based approaches, it has been challenging to move CBT into widespread clinical practice (Emmelkamp et al., 2014; Harvey & Gumport, 2015; Institute of Medicine, 2001; Kazdin & Blase, 2011).
• The trade-off was that some effect estimates were comprised of a small number of primary studies, which could result in underpowered moderator analysis if heterogeneity was present in these pooled effects.
• A greater emphasis is also placed on using behavioral
  coping strategies, especially early in therapy.

Final data entry where disagreement was observed required a consensus review by another author (M.M.). Studies meeting inclusion criteria were English language, peer-reviewed articles published between 1980 and 2018. All types of experimental control were of interest given the importance of this factor in predicting effect size magnitude in the addictions, mental health, and in psychotherapy more broadly (Imel, Wampold, Miller, & Fleming, 2008; Wampold & Imel, 2015; Wampold, Mondin, Moody, Stich, Benson, & Ahn, 1997; Wampold, 2001).