Addiction Treatment Methods Evidence-Based Practices

Cognitive reframing of lapses, coping imagery for craving and life style interventions, such as physical activity are used to help develop skills to deal with craving and broaden the patient’s behavioural repertoire. Cognitive restructuring techniques are employed to modifying beliefs related drug addiction treatment to perceived self-efficacy and substance related outcome expectancies (“such as drinking makes me more assertive”, “there is no point in trying to be abstinent I can’t do it”). Cognitive behaviour therapy (CBT) is a structured, time limited, evidence based psychological therapy for a wide range of emotional and behavioural disorders, including addictive behaviours1,2.

Reframing Negative Thoughts

Overall, the synergy of cognitive restructuring, skills acquisition, and situational management within CBT significantly supports individuals in circumventing the cycles of addiction. The therapy journey emphasizes practical strategies that aim for positive life changes by focusing on present issues rather than delving into the past. As a structured treatment process, several CBT interventions are integrated based on the client’s specific challenges, ensuring the approach remains personalized and effective. Negative emotional states, such as anxiety, depression, anger, boredom are often dealt with by using substances, interpersonal conflicts that the person cognitive behavioral therapy cannot cope with effectively or resolve and the social -pressure to use a substance31.

Unhealthy thinking patterns such as rationalization or denial of substance use can lead individuals increase the addictive behaviours. Recognizing the notion that distorted thinking patterns are the main roots which lead them to perpetuate their addition, individuals become more able to create healthy thinking and behavioural changes (Huppert & Siev, 2010). CBT differs from other addiction treatment methods in Indiana through its focus on present and future change, rather than exploring past experiences. It emphasizes practical, goal-oriented strategies, with clients actively engaging in homework and skill-building exercises to apply what they learn in real life. These CBT techniques are applied in individual therapy sessions, group therapy, or as part of a comprehensive addiction treatment program. In 2015, the criteria for empirically supported treatments were revised and updated to account for the increased volume of treatment outcome research as well as improved methodological rigor and evaluation tools (see Tolin, McKay, et al., 2015 for discussion of specific updates made).

• Attempts to incorporate real-world contingencies into treatment programs areincreasing (Higgins, 1999).Clearly, programs can build contingencies such as take-home medicationprivileges into the structure of their programs.
• A designation of moderate quality, per GRADE, was made because only one meta-analysis of adequate quality was included in the overall evaluation of the evidence (Magill et al., 2019), and this study was considered to have “moderate” quality per AMSTAR2, suggesting it had some limitations but not major flaws.
• It is now believed that relapse prevention strategies must be taught to the individual during the course of therapy, and various strategies to enhance patient involvement and adherence such as increasing patient responsibility, promoting internal attributions to events are to be introduced in therapy.
• Interventions like Cognitive-Behavioral Therapy (CBT) and Dialectical Behavioral Therapy (DBT) are specifically designed to address these issues, helping individuals manage symptoms and develop healthier coping mechanisms.
• CBT is a structured, goal-oriented form of therapy that helps individuals recognize harmful thought patterns and behaviors that contribute to addiction.

The ABCDE Model Applied to Addiction

The CBT approach is also grounded in several global treatment principles that characterize CBT models targeting all varieties of clinical populations and disorders. These include collaborative treatment planning, psychoeducation on the primary clinical problem, therapist modeling of new skills or behaviors, behavioral rehearsal with immediate feedback, and homework assignment and review (D’Amico & Ewing, 2018; McCart https://lichenlekar.com/2024/07/08/sober-living-house-rules-what-to-expect-in-a/ & Sheidow, 2016; Slesnick, Kaminer, & Kelly, 2008). However, the six core elements are not distinct from these principles; on the contrary, each element incorporates various aspects of them, as evidenced below. Also, all CBT models for adolescent populations feature client engagement techniques embedded in early treatment stages (e.g., Webb et al. 2002) and reiterated throughout therapy as needed; these alliance-building and motivational techniques are not covered here.

Avenues Recovery Center at Fort Collins

Mindfulness, is drawn from Zen Buddhist teachings and refers to viewing things in a special way. The mechanisms of mindfulness include being non-judgemental, acceptance, habituation and extinction, relaxation and cognitive change35. These variables are essential in developing distress tolerance and reducing impulsivity, which are important variables in relapse process. Cue exposure is another behavioural technique based on the classical conditioning theory and theories of cue reactivity and extinction12,13.

Preventing relapse

This may further limit our understanding of the impact of CBT on psychosocial outcomes, given these studies are potentially more likely to evaluate psychosocial outcomes and identify effects on psychosocial outcomes (Mehta et al., 2021; Swan et al., 2020). Lastly, additional clarity is needed regarding the conditions under which CBT for SUD might be most effective. One meta-analysis concluded that relapse prevention was more efficacious for alcohol and polysubstance use than smoking or cocaine use (Irvin et al., 1999). Another found that CBT was most effective for cannabis (with similar effect sizes across all other substances; Magill and Ray, 2009), while another indicated no differences in effect sizes by primary SUD (Magill et al., 2019).

Substance abuse often takes a toll on an individual’s physical health, leading to a range of medical issues. Interventions that incorporate medical treatment and health education can help individuals address these concerns and improve their overall well-being. By achieving sobriety and adopting healthier lifestyle habits, individuals can reduce their risk of chronic diseases and enhance their quality of life.

The aim is not to remakepersonality, but rather to help the client address specific, identifiableproblems in such a way that the client is able to apply the basic techniques andskills learned in therapy to the real world, without the assistance of thetherapist. Behavioral therapy focuses more on identifying and changingobservable, measurable behaviors than other therapeutic approaches and hencelends itself to brief work. Treatment is linked to altering the behavior, andsuccess is the change, elimination, or enhancement of particular behaviors. 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. Petry and Martin 15 examined the addition of CM to standard community based treatment (methadone maintenance and monthly individual counseling) for cocaine and opioid dependent patients.

In this article, you will learn about the basics of CBT, how it works, how it can be applied to treat substance abuse disorders, exercises that can be done during therapy sessions, and costs. Focusing on individuals with cannabis use disorders, Budney and colleagues developed a computerized approach encompassing MI, CBT and contingency management (Budney et al., 2015). In a randomized controlled trial, 75 adults with marijuana use disorder were randomized to 2 sessions of brief treatment versus a 9-session clinician-delivered MET-CBT approach, or a 9-session version of TES emphasizing MET and CBT. Both MET/CBT conditions included a CM component in which participants could earn up to $435 in gift cards if all urines were negative for cannabis. Significantly more participants in clinician-delivered treatment (44.8%) and TES (46.7%) were abstinent at the end of treatment compared with the 2-session brief treatment (12.5%).

By targeting such cognitive and behavioural processes, CBT teaches individuals the necessary skills to resist cravings with healthier coping mechanism, making healthier choices and maintaining longer term recovery (McHugh et al., 2010). A key emphasis throughout the article has been on the pivotal role of CBT in addressing the cognitive and behavioral aspects inherent in substance abuse. The theoretical foundation elucidated the cognitive restructuring and behavioral modification techniques that form the core of CBT, while the application section detailed how these techniques are deployed in the assessment, goal-setting, and intervention phases of substance abuse treatment. CBT’s ability to target distorted cognitions and modify maladaptive behaviors underscores its relevance in comprehensively addressing the complexities of addiction. Despite the overall positive findings, it is imperative to critically examine the limitations and challenges in CBT research within the context of substance abuse treatment. Methodological issues, such as variability in study designs, outcome measures, and sample characteristics, may impact the generalizability of findings.

The studies reviewed above highlight both the promise of technology-based interventions as well as their significant limitations, which include highly variable rates of retention and adherence and poor rates of follow-up, particularly for studies collected entirely on-line (Kiluk et al., 2010). Several studies have used use wait-list controls, hence limiting the inferences that can be drawn regarding the efficacy of the intervention evaluated. Issues of privacy and confidentiality are particularly important to consider when dealing with individuals who are users of illicit drugs, particularly in the era of electronic medical records (Ramsey et al., 2016).