Chapter 4 Brief Cognitive-Behavioral Therapy Brief Interventions and Brief Therapies for Substance Abuse NCBI Bookshelf

It
is thought that the anticipated positive effects of substances serve as an
incentive or motivation to use. Conversely, negative expectancies are
thought to act as a disincentive and contribute to reduced drinking or drug
use (McMahon and Jones, 1993;
Michalec et al., 1996). Neidigh and colleagues investigated the strategies employed to cope with
stress and the temptation to drink among individuals attempting to
control their drinking (Neidigh et
al., 1988). They found that both cognitive and behavioral
coping strategies were effective in resisting a drink. First, there appears to be a
considerable degree of situational specificity in the coping process. That is, different types of substance-related situations seem to require
different types of coping responses rather than a general coping
strategy’s being equally effective across situations.

It also assumes that
over the course of time, substance abusers develop a particular set of
effect expectancies based on their observations of peers and significant
others abusing substances to try to cope with difficult situations and
through their own experiences of the positive effects of substances. They
have come to believe that substances have positive benefits that are more
immediate and prominent than their negative consequences. Attributional styles play a major role in the cognitive-behavioral theory of
substance abuse disorders (Davies,
1992; Marlatt and Gordon,
1985). The nature of substance abusers’ attributional styles is
thought to have considerable bearing on their perception of their substance
abuse problem and their approach to recovery. An alcohol-dependent client,
for instance, may believe that he drank because he was weak (an internal
attribution) or because he was surrounded by people encouraging him to have
a beer (an external attribution). He may believe that his failure to
maintain abstinence shows that he is a weak person who can never succeed at
anything (a global attribution) or that a drinking episode does not
represent a general weakness, but was instead due to the specific
circumstances of the moment (a specific attribution).

CBT Effect by Contrast Type, Outcome Type, and Follow-up Time Point

Finally, the sample was distributed in roughly equal thirds with respect to the types of conditions to which combined CBT and pharmacotherapy was compared; narrative results and Tables 1 and 2 are organized by these clinically informative subgroups, and given the distinctiveness of these comparator conditions, no overall pooled effect size is reported. Modern day CBT for addiction is decidedly integrative and increasingly so as the applications evolve to reach novel and understudied populations. If you have questions about your coverage, cognitive behavioral interventions for substance abuse call the number on your insurance card to find out more information about your specific plan. Others may be out-of-network (OON) but offer patients the option of paying their therapy costs up-front and then sending a superbill to their insurance company for reimbursement. In that case, the therapist gives the client the paperwork necessary to submit their insurance claim directly to their provider. As part of cognitive restructuring, expectancies, or beliefs about the consequences of use, are another important target for intervention.

• Non-significant pooled effects, in contrast to a specific therapy, across outcome types and follow-up time point was observed in the present study.
• The following case study involves a young male cocaine user who has sought
  outpatient treatment.
• Meaning 
  These findings suggest that best practices in addiction treatment should include pharmacotherapy plus cognitive behavioral therapy or another evidence-based therapy, rather than usual clinical management or nonspecific counseling services.
• This change in perspective will help reduce the client’s sense of
  helplessness and loss of control.

However, the model that appears to have the greatest impact and lasting
influence uses the idea of performance accomplishments to enhance client
self-efficacy. Annis and Davis use graduated homework
assignments to help in this process (Annis and Davis, 1988b). The client gradually exposes herself to
increasingly difficult situations with greater relapse risk but does so
without using.

When To Use Cognitive-Behavioral

Behavioral therapy focuses more on identifying and changing
observable, measurable behaviors than other therapeutic approaches and hence
lends itself to brief work. Treatment is linked to altering the behavior, and
success is the change, elimination, or enhancement of particular behaviors. When I2 estimates exceeded 50%,33 primary drug outcome was tested as an effect-size moderator. We conducted other sensitivity analyses, including trimmed estimates with influential studies (ie, a study that, if removed, would change the substantive interpretation of the pooled effect size) removed and tests for publication bias.

• With regard to addictive behaviours Cognitive Therapy emphasizes psychoeducation and relapse prevention.
• In early work, these outcomes showed effect sizes nearly double those for substance use, which is important given they may be of equal or even greater importance to stakeholders such as providers, patients, and families.
• To determine the participants’ demographic characteristics, descriptive statistics including absolute and relative frequency distribution, mean, and standard deviation were used.
• When non-specific therapies or usual care were the contrast, the pooled effect size was small to non-significant.
• For
  substance abuse disorders, these goals will, of course, involve a
  reduction in or cessation of substance use.

For a review
of assessment tools that can be used in developing a functional analysis see
TIP 35, Enhancing Motivation for Change in Substance Abuse Treatment
(CSAT, 1999c). Before focusing more specifically on the cognitive-behavioral model, this chapter
examines the behavioral and cognitive theories and therapies that serve as the
foundations of and have contributed significantly to the cognitive-behavioral
approach to substance https://ecosoberhouse.com/ abuse treatment. Both behavioral and cognitive theories have
led to interventions that individually have been proven effective in treating
substance abuse. Several of these are reviewed, as they have been successfully
incorporated into an integrated cognitive-behavioral model of addictive behaviors
and their treatment. Behavioral therapies are also suited to dimensional approaches to substance use disorder treatment.