“If I have lost confidence in myself, I have the universe against me.“
Ralph Waldo Emerson
This opening quote by Emerson evokes a concept that exists at the forefront of addiction therapy programs and mental health treatment programs. Addiction and mental illness tend to rob those who struggle of the ability to think clearly, make good decisions, feel confident about the future, and make healthy choices. While the consequences of these conditions can be severe, the right treatment program can restore confidence and the ability to think clearly. A cognitive-behavioral therapy program is one such treatment.
Becoming a Detective
Unlike traditional psychoanalysis, where the patient plays a passive/listening role, cognitive-behavioral therapy (CBT) requires active participation from the person in treatment. During CBT sessions, patients and their therapists develop theories and think of new ways to change old habits that are then tested in real life.
According to the Association for Behavioral and Cognitive Therapies, CBT is designed to help people determine what is supporting poor behavior and what needs to change for that behavior to stop. CBT is often called a “targeted therapy” for this reason. While prior trauma, childhood issues, or other triggers may have played a role in the start of the behavior, the emphasis is on what is happening right now.1 The sessions tend to move quickly and often bring results in a short period of time.
According to the Association for Behavioral and Cognitive Therapies, CBT is designed to help people determine what is supporting poor behavior and what needs to change for that behavior to stop.
Structure Is Key
In order for the cognitive-behavioral therapy program to begin working, CBT sessions are highly structured.
Instead of talking about the week or a patient’s reactions to old stimuli in a free-form manner, the sessions use the following format:
- A brief mood check
- A review of the last session’s work
- Setting an agenda for the session
- A review of the week’s homework
- Patient outlines challenges coming up in the next week
- Therapist and patient develop strategies to handle those challenges
- Patient is assigned homework based on listed challenges
- Session ends2
According to the Mayo Clinic, CBT sessions may last only 45 to 60 minutes, but the assigned homework takes much longer to complete. The homework plays a key role in the effectiveness of CBT.1
A New Way of Thinking
During addiction treatment, it is crucial to help the person struggling with addiction understand the reasons for drug relapse. CBT encourages people to break apart a relapse, looking for relapse triggers and when resistance began to fade. When a person can identify these factors, the rehab team can develop strategies to help them avoid them in the future.
People who have numbed their minds with drugs and alcohol may have difficulty dealing with powerful emotions like grief, anger, or loss. The person in treatment may have no idea how to deal with the rising tide of emotion, and the temptation to use again becomes overwhelming. CBT teaches mindfulness techniques that allow those in recovery to live in the moment and recognize the pain they feel now will dissipate with time. Some therapists provide meditation or muscle relaxation lessons, encouraging their patients to use these techniques when deep emotions threaten to overwhelm them.
CBT is also used to treat depression and other forms of mental illness. According to the National Alliance on Mental Illness, people who receive CBT do better in treatment than patients who do not.
CBT has also been effective in treating other mental illnesses, such as:
- Social phobias
- Personality disorders
- Eating disorders
- Psychotic disorders
People who struggle with mental illnesses and substance abuse also benefit from CBT. Patients with these co-occurring disorders learn to control their symptoms without turning to drugs or alcohol.
CBT is often combined with medication management for those recovering from addiction to drugs like heroin or other opioids. Because opioids cause physical and psychological dependence, combining medications and CBT is often the best way to help these people improve.
CBT Program in Palm Springs, California
CBT is an individualized approach to treatment for mental illness and addiction. Putting the patient in control over how much of the treatment is delivered and how success is measured can be one of the greatest benefits of this treatment approach.
1 “Cognitive Behavioral Therapy.” Mayo Clinic, Mayo Foundation for Medical Education and Research. 29 Dec. 2017.
2 Weinstock, Marjorie. “Staff Perspective: CBT for Depression – Elements of Session Structure.” Center for Deployment Psychology. 24 June 2016.