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January 22, 2021

Cognitive-Behavioral Interventions Targeting Alcohol or Other Drug Use and Co-Occurring Mental Health Disorders: A Meta-Analysis

Filed under: Sober living — новый @ 12:33 pm

The majority of derived effects were homogeneous, suggesting that the selected subgroup variables (i.e., contrast type, outcome type, and follow-up time point) were informative modifiers of CBT effects5. In the current study, the results of data analysis indicated that the level of aggression was higher cognitive behavioral interventions for substance abuse than the average level before the intervention. This is compatible with the results of some studies [3, 18], but not consistent with some others [19]. Increase of aggression among patients and other society members can be attributed to high levels of stress in urban and industrial communities.

cognitive behavioral interventions for substance abuse

It is not uncommon to find that patients maintain a belief that use of a particular substance will help some problematic aspect of their life or given situations. For example, a patient may believe that a family holiday would not be enjoyable without alcohol use. Similar to cognitive restructuring techniques, evaluating evidence for expectancies and designing behavioral experiments can be used to target this issue. In this instance the patient would be encouraged to refrain from drinking at the holiday party and assess the degree to which the event was enjoyable. In addition, the patient could evaluate evidence from past holidays to compare the consequences and benefits of alcohol use in these settings. Although empirical support for these interventions is promising, it is most often garnered through efficacy studies in which the treatment is carried out under optimal conditions.

How Is CBT Used in Therapy?

Strategies for coping with negative affect, such as using social supports, engaging in pleasurable activities, and exercise can be introduced and rehearsed in the session. The development of pleasurable sober activities is of particular importance given the amount of time and energy that is often taken for substance use activities (i.e., obtaining, using, and feeling the effects of substances). When reducing substance use, patients can be left with a sense of absence where time was dedicated to use, which can serve as an impediment to abstinence. Thus, concurrently increasing pleasant and goal-directed activities while reducing use can be crucial for facilitating initial and maintained abstinence. During assessment and early treatment sessions, case conceptualization requires consideration of the heterogeneity of substance use disorders.

cognitive behavioral interventions for substance abuse

More recent developments in the area of managing addictions include third wave behaviour therapies. Third wave behaviour therapies are focused on improving building awareness, and distress https://ecosoberhouse.com/ tolerance skills using mindfulness practices. These approaches have shown promise, and more recently the neurobiological underpinnings of mindfulness strategies have been studied.

Cognitive behavioural interventions in addictive disorders

For example, the relative contribution of affective and social/environmental factors can vary widely across patients. A patient with co-occurring panic disorder and alcohol dependence may be experiencing cycles of withdrawal, alcohol use, and panic symptoms that serve as a barrier to both reduction of alcohol consumption and amelioration of panic symptoms. [56] Alternatively, patients without co-occurring psychological disorders may face different barriers and skills deficits, such as difficulty refusing offers for substances or a perceived need for substances in social situations. The largest treatment trial to date, Project MATCH[49] had 1726 subjects with alcohol use disorders who were randomly allocated to MET, CBT or TSF. The main outcome measures were the percentage of days/month that the client did not drink and the number of drinks they had in each drinking session. The results showed an increase in abstinence days from 20-30% to 80-90% and decrease in drinks per drinking day from to 1-4.

  • More recent developments in the area of managing addictions include third wave behaviour therapies.
  • 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.
  • CBT is one of the most researched forms of treatments, so there is an abundance of evidence and support for its use with a variety of mental conditions, including alcohol and substance use disorders.
  • Clearly the full
    intervention plan would require further assessment and a functional
    analysis; however, a direction for further treatment can already be seen in
    this brief interchange.

Novel treatment strategies including more scalable modalities (such as computer-based programs) and combination strategies to improve rates or speed of treatment response (such as DCS) may aid in the transportability of treatments outside of research settings. Cognitive behavioral therapy (CBT) approaches have among the highest level of empirical support for the treatment of drug and alcohol use disorders. As Psychology of Addictive Behaviors marks its 30th anniversary, we review the evolution of CBT for the addictions through the lens of the Stage Model of Behavioral Therapies Development. The large evidence base from Stage II randomized clinical trials indicates a modest effect size with evidence of relatively durable effects, but limited diffusion in clinical practice, as is the case for most empirically validated approaches for mental health and addictive disorders. Technology may provide a means for CBT interventions to circumvent the ‘implementation cliff’ in Stages 3–5 by offering a flexible, low-cost, standardized means of disseminating CBT in a range of novel settings and populations.