Of the facilities that participated in the 2012 National Survey of Substance Abuse Treatment Services, 91 percent used Cognitive Behavioral Therapy (CBT) either alone or in combination in order to help patients struggling with drug or alcohol addictions. This means CBT is one of the most accepted therapies available for people who have addiction issues, and it means that people who enroll in treatment programs are likely to encounter this type of treatment at least once. Knowing more about how the treatment works, and how people can get the most out of this type of care, could help families to prepare for the work that’s ahead of them.

A Targeted Solution

Rather than enrolling in therapy programs that might take months or years to complete, people who participate in CBT are often done with their work in a short period of time.

A Specific Set of Skills

CBT is designed to teach people a specific set of skills, according to the Association for Behavioral and Cognitive Therapies, and as a result, people participate in just six to 20 sessions.

But there’s a significant amount of work that goes on while a person is enrolled in CBT. Often, patients work in a one-on-one relationship with a mental health professional, such as a counselor, therapist or psychologist, and the professional and the patient meet several times each week in sessions that last for an hour or longer. Here, the two have collaborative discussions about addiction, attempting to determine:

  • What prompted the person to use drugs
  • What thoughts or assumptions might keep the person using drugs
  • How changing an underlying thought or assumption might reduce drug cravings
  • What things the person might do instead of using drugs or alcohol

In the beginning of a CBT session, patients are encouraged to discuss the events that transpired between the last session and the current appointment. They might outline situations that seemed to prompt a craving for drug use or another destructive behavior, and they might discuss how their decisions either worked or did not work, in terms of keeping them safe. The counselor and the patient use those situations to help patients understand how a similar situation might be handled in the future.

Then, patients discuss one or two upcoming challenges they’re facing, along with their assumptions about how they might react and what might happen. The two might plan for that new situation, outlining how the patient might behave or what the patient might do in order to stay safe.

Dealing with challenges means developing a new set of skills, and that’s a big part of each and every CBT session. In some cases, patients are encouraged to develop skills related to mindfulness or meditation, so they can accept negative thoughts without feeling the need to act on them. Sometimes, patients are encouraged to explore other activities that bring them a sense of relaxation or pleasure, so they’ll be less likely to self-medicate with drugs. Sometimes, too, patients are taught to develop communication or assertiveness skills, so they’ll be less likely to seek out numbing with drugs.

Picking up new skills and changing old thought patterns isn’t easy, and homework plays a big role in CBT. When patients aren’t in therapy sessions, they might be reading educational materials, writing journal entries, trying out new techniques in controlled experiments and otherwise actively working on changing their lives. They might outline their experiences with the homework in the next session, and the course of treatment might change a little depending on how well the previous week was, but more homework is likely to follow each and every treatment session. Constant practice like this is mandatory.

At the end of each CBT session, patients are encouraged to provide feedback on how the therapy is working and how well things are progressing. This feedback is vital, and often, the therapy shifts and adjusts depending on the patient’s perception of the helpfulness of the therapy.

Making CBT Work

The rapid pace of CBT leaves little time for laziness or ambivalence. Patients who really want to get better with this method of care need to be willing to keep their appointments and perform each and every homework lesson, so they’ll be able to stay on track and really get better. Those who do stick to the program and remain dedicated to the idea of getting well stand the best chance of long-term improvement.

In addition to working hard and sticking to appointments, the Mayo Clinic suggests that people can get the most out of CBT by developing an open, honest, collaborative partnership with the person who is providing the care. Counselors need access to a person’s inner thoughts and feelings in order to provide help, and they need to understand how well the therapy is working as the sessions progress, so they can switch up the approach if something isn’t working well. Patients who clam up and keep secrets don’t provide their counselors with the information they need, and in the end, that hurts the patient more than it hurts the counselor. People really need to keep their goals in mind and stay open, in order to get the most from CBT.

Finding Comfort with CBT

Often, people who participate in CBT begin to see changes after just a few sessions. But sometimes, people who get CBT need just a little more assistance in order to reach a therapeutic breakthrough. For example, the National Institute of Mental Health suggests that people who have bipolar disorder often need to take mood-stabilizing medications in order to feel a real improvement in their mental health. CBT might help, but they might also need medications in order to reduce their symptoms.

Similarly, some people benefit from participating in a slightly modified version of CBT. For example, some people find that the rapid pace of change CBT demands leaves them feeling bullied or unaccepted. They may benefit from a modified version of CBT that uses a slower pace and emphasizes support and understanding over rapid change. They’ll still have the opportunity to understand their behaviors and amend their ways, but the slower pace of therapy might allow them to feel a little more comfortable.

There are some people who simply don’t benefit from CBT at all, according to an analysis on Psych Central, as these people might have vague problems they cannot name. They might be unable to target specific thoughts or behaviors with therapy, simply because they’re unaware of the specific situations that impair their mental health. People like this might benefit from global approaches, including general psychotherapy, so they can come to a deeper awareness of their motivations and their challenges. At that point, they might be prepared to heal with CBT.

But even people who do benefit from CBT are likely to utilize other therapies in a drug addiction treatment program, including:

These additional forms of therapy might provide lessons that are just a little bit different, and that might help to augment the education people receive in their CBT sessions and allow a deeper form of healing to take hold.

Therapy Choices at Black Bear Lodge

CBT is just one option we provide for patients at Black Bear Lodge. This technique allows us to really focus on the thoughts and behaviors that lie beneath a drug or alcohol abuse issue, and by using CBT, we can help our patients to make a number of profound changes in a short period of time. But we’re careful to ensure that our patients have an entire suite of therapies available to help them heal. Some of our patients aren’t ideal candidates for CBT, and we’re always able to provide an alternate therapy that could bring about big changes. If you’d like to know more about this, please call. We’d love to help.