Aim of CBT
To help patient recognise problematic situations and triggers and to either avoid these or learn how to deal with their problematic behaviour
Drugs that help with detoxification
Benzodiazepines, methadone, buprenorphine/naloxone
Preservation treatment
Treatment method that involves prescribing medication that has the same chemical properties as the drug to which the person is addicted -> can prevent withdrawal symptoms and craving
Assumptions of CBT
- learned
- therapeutic alliance
- present focus
- client therapist
- guided discovery
- scientist-practitioner (collaborative empiricism)
How does CBT build therapeutic alliance?
- collaboration & participation
- effective treatment experience
- therapist variables
Within structure of session CBT
- review/recap of week (homework, issues that arose) + agenda setting
- introducing the session theme
- planning for the next session
Relapse prevention
Therapy form that mainly aims to develop skills to identify and prepare for high-risk situations that lead to relapse to substance use
- self efficacy + cravings + coping
2 factors of focus of cognitive therapy
- proximal situational factors
- distal background factors
4 main components of Coping skills therapy
- relapse prevention training
- social and communication skills training
- training in coping with urges/cravings
- mood management
Mindfulness-based CBT
Approach to therapy that involves the practice of mindfulness
Mindfulness= purposeful attention to the present and an openness to accept things as they are
Variation in CBTs for alcohol and other drug problems
- brief CBT
- low intensity CBT
- digital CBT
Brief CBT
More brief interventions that primarily focus on relapse prevention or coping skills therapy
Low intensity CBT
Interventions that are low intensity for the practitioner + sometimes less intensive for the client -> can be delivered by non-specialist + self-directed techonologies
=> increase access, flexibility, responsiveness, cost-effectiveness
Digital CBT
Computer-delivered interventions that can help overcome problems of accessibility
6 main elements of CBT
- early experiences
- beliefs (core beliefs/schemas)
- triggers (internal or external)
- thoughts
- feelings
- behaviour
3 categories of thought and belief-based interventions
- analysing approach
- challenging approach
- accepting approach
Analysing approach of thought and belief-based interventions
Identifying thoughts and beliefs and their relationship to feelings and behaviour and considering the helpfulness or un-helpfulness of them
Challenging approach of thought and belief-based interventions
Analysing thoughts and beliefs as in the analysing approach and utiliying challenging strategies to develop modified/ alternative thoughts and belefs
Accepting approach of thought and belief-based intervention
Noticing and accepting thoughts and beliefs without judgement or necessary further action
Motivational Interviewing (MI)
Collaborative, goal-oriented conversation style that is designed to enhance personal motivation + commitment to a particular goal by eliciting + exploring a person‘s reason for change in atmosphere of acceptance and compassion
Components of MI
Engaging
Focusing
Evoking
Planning
How to evoke change talk
Ask
Reflect
Affirm
Summarize
Decisional balance (vs. MI)
Interviewing approach that is about exploring all reasons for and against change
-> more of a non-directive method of helping people make decisions without influencing their choicechoice
Community reinforcement approach
Seeks to establish/reestablish natural competing sources of reward that do not depend on substance use
