Introduction
Over the years, psychologists and mental health practitioners have uncovered unique solutions to treat mental health disorders and address the implications of drug addiction and substance abuse. Particularly, non-pharmacological methods have proved to be effective in situations when drug administration poses safety risks or is inappropriate. Several drug-free psychotherapy models provide frameworks to guide counselors in interpreting patients’ behaviors, empowering them, and helping them navigate the challenges of substance abuse. However, different approaches are advisable and effective in cases exhibiting certain characteristics. Cognitive Behavioral Therapy (CBT) is a comprehensive treatment approach initially developed for depression cases. Nevertheless, it is recommended for substance abuse and addiction cases as it can facilitate sustainable changes. Thus, the following passages discuss the application of cognitive behavioral therapy as a remedy for alcohol abuse disorder. The sections cover the basics of CBT and recommended techniques to guide an alcohol use disorder patient toward making better decisions.
The Basics of Cognitive Behavioral Therapy
Cognitive-behavioral therapy is a mental condition treatment first proposed by Dr. Aaron T. Beck in the 1960s. The approach leverages the influences of an individual’s thoughts on their feelings and behaviors. In other words, the model proposes a strong association between what an individual thinks, how they feel, and their actions. Thus, it guides patients into recovery by informing them of how their thought processes can interfere with their emotions and behaviors (Ray et al., 2019). The ultimate goal of CBT is to increase a patient’s awareness and facilitate a better understanding of what initiates their substance abuse. Subsequently, it allows individuals to note the factors that contribute to their behaviors, acknowledge their weaknesses, and implement changes. According to Ray et al. (2019), CBT is a successful technique to help alcoholics recover from addiction, especially when combined with pharmacological interventions. However, the therapy is also reliable when applied as a standalone technique.
CBT for an Alcohol Use Disorder Patient
The initial phase of cognitive behavioral therapy is functional analysis. This process entails investigating the causes and outcomes of a particular behavior, in this case, excessive alcohol consumption. Thus, the beginning of CBT therapy will focus on uncovering the feelings, thoughts, and circumstances that predispose the individual to alcoholism and the outcomes of their experiences after drinking alcohol. When performing functional analysis, it is critical to ask individuals questions about their alcohol use and their willingness to commit to an improvement plan (Magill et al., 2019). These questions should revolve around their feelings before they start drinking, their emotions after drinking, their memory of the events, positive implications or benefits, and the negative experiences or aftermath. Functional analysis is vital at this stage since it will inform initiatives toward developing a plan to address the individuals’ needs. Moreover, it will provide insight into why the patient drinks and is unable to control their alcohol intake behaviors.
The functional analysis stage also pays attention to a patient’s thought records to allow them an opportunity to tap into their conscious and subconscious minds. Thought records obligate patients to examine their inner thoughts, associated emotions, and the situations that contribute to the revelation of these thoughts. The thoughts records process aims to reconcile an individual’s thought process with their willingness to cope (Brink & Schoevers, 2019). To put it in another way, thought records enable individuals struggling with difficulties to note contributing factors and adopt better ways of managing these situations or emotions. Moreover, familiarizing themselves with these thoughts enables the adoption of better techniques to suppress negative feelings whenever they arise instead of using alcohol. For example, an employee may be suffering through tough times, coupled with increased pressure from managers who disregard their efforts (Magill et al., 2019). As a result, they may perceive alcohol as a tool to get rid of their emotions. However, realizing that other people’s opinions will not have an impact on their delivery can help them limit alcohol intake and avoid drinking for unnecessary reasons.
Another practical exercise to initiate positive reinforcement in alcohol abuse patients is behavioral experiments. Behavioral experiments refer to activities that allow the patient to compare and contrast their positive vs. negative thoughts to identify the ones most effective in facilitating behavior change. Behavioral experiments are critical in personalized CBT solutions since people react differently to treatments and respond based on varying factors (Ray et al., 2020). For example, some individuals react better to self-kindness and less assertive approaches to improvement. As a result, convincing them that they are better off and would greatly improve their living standards without drinking alcohol can encourage them to alter their behaviors. On the other hand, some people respond to self-criticism, thus encouraging them to adhere to more strict stipulations and a routine to avoid alcohol at all costs (Brink & Schoevers, 2019). Therefore, behavioral exercises will enable acknowledging the patient’s weaknesses and strengths and the development of a technique that will allow them to take matters into their hands. In the process, the patient will figure out what works best for them and how to avoid risk factors that might facilitate a relapse.
Imagery-based exposure is also a strategy adopted by mental health practitioners in CBT to reduce the impact of negative thoughts and emotions from an individual’s past on their current behaviors. Behavioral theorists argue that some individuals experience emotional instability due to traumatic sounds, sights, and memories they hold onto in their subconscious minds. Occasionally, these memories come back to haunt them, resulting in several adverse reactions like anxiety and mood swings that people to abuse drugs (Magill et al., 2019). However, imagery-based exposure involves revisiting these memories and slowly reconciling with the feelings and emotions they bring. Over time, these exercises can help individuals limit the anxiety associated with these feelings and control their actions. Imagery-based exposure can also help an individual to come to terms with losing someone close and deal with other painful memories that may contribute to excessive drinking (Magill et al., 2019). Occasionally revisiting these memories will make them less painful and reduce an individual’s need to self-medicate using alcohol. Ultimately, the patient will be better positioned to avoid a potential relapse as they will be aware of their feelings and the reasons for their emotions.
Although most patients dealing with substance abuse and addiction are always willing to change their behaviors, they are exposed to environments that do not support their initiatives, thus increasing their chances of falling back to their bad behaviors. Thus, the CBT program will also include a pleasant activity schedule involving comprehensive planning of the week’s activities to enhance accountability and avoid exposure to unsupportive environments (Ray et al., 2020). A pleasant activity schedule breaks down a list of healthy and fun activities to engage a patient throughout the week, especially during periods when they are not occupied. The fun and pleasant activities can include hobbies and sports like swimming, playing soccer, jogging, and similar activities. Moreover, the schedule will include social activities and support group programs that the patient can observe to improve their emotional well-being and avoid negative thoughts. In addition, the schedule will contain basic practices to reinforce positive thoughts and encourage the individual to live a fruitful life without depending on alcohol.
Finally, it is crucial to take the patient through coping skills training to help them cope with their difficult situations and provide them with other solutions to feel better apart from alcohol and other substances. Alcohol is used by many people as a way of coping with challenges. However, some individuals may lose control or become overwhelmed with their problems, resulting in their inability to control their drinking behaviors (Brink & Schoevers, 2019). The main goal of CBT is to help an individual refrain from adverse behaviors willingly by learning better coping skills. Thus, it is critical to inform individuals of some skills to apply in situations that may trigger their alcohol use. A recommended skill that individuals struggling with alcohol disorders should learn is how to tolerate negative feelings and emotional distress. People going through depression and trauma perceive taking alcohol as a quick fix. Nevertheless, acknowledging that alcohol will not solve the problem can help make better decisions.
It is essential to deliver supplementary CBT training in behavior management and social development. For example, taking the patient through assertive training exercises will help to improve his relationship with his peers and other people in his social circle. In addition, providing self-evaluation and monitoring training equips the patient with the skills required to observe their habits and progress over time. Moreover, relaxation training to limit stress and anxiety can come in handy in unprecedented situations (Ray et al., 2020). Similarly, taking the patient through self-monitoring education and cognitive restructuring activities will facilitate improving their self-confidence, insight and decision-making capabilities, and thinking patterns. Continuously working on these exercises will ensure that the patient achieves their long-term goals.
Conclusion
Drug and substance abuse is a highly prevalent public health risk that is slowly developing into a crisis, given the rising number of drug use and addiction cases in communities. However, substance abuse does not only affect its victims but the whole society since it interferes with individuals’ productivity, relationships, and comfort. Hence, it is critical to devise practical solutions to deal with drug addiction and the implications of drug abuse. Behavioral cognitive theory is a cutting-edge non-pharmacological technique used to treat mental health issues and drug addiction in individuals who are not responsive to medication. The approach takes advantage of an individual’s thought processes and thinking patterns to influence their emotions and behaviors. Generally, the approach is effective because it promotes self-initiative towards recovery. Moreover, it informs individuals of the reasons why they exhibit certain destructive behaviors and how to limit contributing factors. Thus, the technique is recommended for patients struggling with alcohol use disorder because of its high success rates and safety.
References
Magill, M., Ray, L., Kiluk, B., Hoadley, A., Bernstein, M., Tonigan, J. S., & Carroll, K. (2019). A meta-analysis of cognitive-behavioral therapy for alcohol or other drug use disorders: Treatment efficacy by contrast condition. Journal of Consulting and Clinical Psychology, 87(12), 1093. Web.
Ray, L. A., Bujarski, S., Grodin, E., Hartwell, E., Green, R., Venegas, A., Lim, C. A., Gillis, A., & Miotto, K. (2019). State-of-the-art behavioral and pharmacological treatments for alcohol use disorder. The American Journal of Drug and Alcohol Abuse, 45(2), 124-140. Web.
Ray, L. A., Meredith, L. R., Kiluk, B. D., Walthers, J., Carroll, K. M., & Magill, M. (2020). Combined pharmacotherapy and cognitive behavioral therapy for adults with alcohol or substance use disorders: a systematic review and meta-analysis. JAMA Network Open, 3(6), e208279-e208279. Web.
Van Emmerik-van Oortmerssen, K., Vedel, E., Kramer, F. J., Blankers, M., Dekker, J. J., van den Brink, W., & Schoevers, R. A. (2019). Integrated cognitive behavioral therapy for ADHD in adult substance use disorder patients: Results of a randomized clinical trial. Drug and Alcohol Dependence, 197, 28-36. Web.