Cognitive-Behavioral Therapy (CBT) is now widely used to combat many forms of substance use disorders as well as mental disorders due to its initial successes in treating alcohol addiction. The therapy works on the principle that people respond reactively to stresses based on past experiences and traumas, rather than applying rational thinking. People with these disorders have developed maladaptive coping mechanisms. They are more likely to turn to alcohol and drugs to “numb” their emotional or physical suffering.
Cognitive behavioral therapy identifies these problem areas or triggers and reconditions the individual to cope with these stresses. The effect is one that is shown to reduce overall anxiety, depression, and cravings for alcohol.
The brevity of the program, in ongoing sessions, makes CBT an attractive and affordable option for many seeking treatment for alcohol addiction. It is also a therapy covered by many types of insurance, and as a mode of treatment, may be used alone or in conjunction with other methods of treating addiction.
Goals Of Cognitive Behavioral Therapy In Treating Alcohol Addiction
The primary goal of cognitive behavioral therapy in treating alcohol addiction involves identifying issues or past traumas that still affect the individual today. These traumas can create triggers, resulting in cravings for alcohol whenever a memory or associated stress arises. By reducing the effects of those stresses through the development of positive coping skills, opportunities for cravings to arise are also reduced.
Another goal of the program is to change negative thought patterns associated with these past traumas or stresses to new and proactive coping skills. During a three to four month period, a therapist works closely with the alcohol-addicted individual to build useful coping strategies and provide tools to aid them in identifying triggers and addressing these triggers constructively, rather than reactively.
There are six phases in CBT including an initial assessment, reconceptualization: the process by which an individual learns to conceptualize their situation, surroundings, or feelings differently, the development of positive coping strategies, and a post treatment assessment to see how the individual is applying these new skills some time out from the last session.
Phases of Cognitive Behavioral Therapy
- Skills building
- Skills consolidation and application training
- Generalization and maintenance
- Post-treatment assessment
Cognitive Behavioral Therapy And Gender In The Treatment Of Alcohol Addiction
Research has demonstrated genetic predisposition is a primary risk factor for addiction. The Alcoholics Anonymous 12-step program recognizes in the first step that someone is powerless in controlling the addiction. Other risk factors for addiction include socioeconomic and environmental factors and past trauma. For those who suffer from an addiction with risk factors associated with past trauma or other problem areas in their lives, CBT treats the maladaptive behaviors that may have resulted in the substance use disorder. Reasons differ between men and women as to why they begin drinking. These reasons may play a pivotal role in determining the most direct approach to treating the addiction.
Studies have shown a slight advantage for women applying cognitive behavioral therapy over men. This may be due in part to the greater prevalence co-occurring anxiety and depression in women, often due to sexual and physical traumas and other gender-based disparities addressed through CBT.
Awareness of the root causes of problem drinking in women versus men make cognitive behavioral a more prominent emerging therapy in treating the disorder among women. Overall effectiveness is improved for both men and women when CBT is combined with other therapies, including AA.
Cognitive Behavioral Therapy As Part of Comprehensive Alcohol Treatment Plan
Cognitive behavioral therapy, while effective in controlling drug cravings, is most effective when used in conjunction with medications or other therapies and can be a powerful tool when part of a comprehensive alcohol treatment plan.
Often motivational enhancement therapy (MET) is used as part of a comprehensive treatment plan involving CBT in addressing substance use disorders. Motivational enhancement therapy is designed to reduce an individual’s apprehension about getting treatment for an addiction.
Cognitive behavioral therapy is a nice compliment to 12-step programs like Alcoholics Anonymous, encouraging the assessment of coping strategies and addressing each, while also building a social support network so vital to both treatment types. Research has shown CBT is more effective when combined with other treatment types, including AA, as well as pharmacologic interventions.
One study compared CBT used in conjunction with the medication naltrexone, an opioid antagonist used to reduce alcohol cravings and in lessening the effects of alcohol, to a placebo control group. The control group suffered a 60 percent relapse rate compared with 38 percent in the CBT/naltrexone group, indicating increased effectiveness where both therapies were used in conjunction.
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