Cognitive behavioral therapy (CBT) has become among the most widely used therapeutic interventions for the treatment of alcoholism and addiction. In fact, it appears to rank among the most widely utilized forms of therapy in general. Fueled by evidence-based research and countless success stories, it earns its place in therapists’ offices from coast to coast. Applications of CBT include the treatment of: substance use disorders; eating disorders; sleep disorders; hypersexual disorder; PTSD and childhood trauma; anxiety; depression; and a wide array of behavioral addictions.
This wide array of applications offers only a small sample size of CBT’s many current uses. Rooted in the ancient Greek philosophies of Stoics such as Epictetus and validated by modern studies, therapists turn to cognitive behavioral therapy when treating a patient in need of goal-oriented focus. One reason for its diverse variety of applications is that it allows for the inclusion of several other therapeutic methods. Your typical CBT practitioner may easily turn to reality therapy, relaxation training, dialectical behavior therapy or even mindfulness practice. They can adjust their methods as the situation calls for it.
Due to its flexibility, one could fill entire textbooks without completely elucidating the methods, applications, and primary benefits of CBT. For our purposes, however, a simple overview may suffice. Allow us to explain not only why cognitive behavioral therapy works, but also why we specifically choose to employ its methods at New England Recovery and Wellness. You’ll find that it not only works on its own, but also serves as a suitable complement to some of the other program features that we offer here at RAW.
How Cognitive Behavioral Therapy Works
Cognitive behavioral therapy generally proceeds in six stages, beginning with the initial assessment. A standard CBT assessment serves to identify behaviors in need of changing and determine their intensity, something we cover in our preliminary evaluation of every client. Since our intake and admissions teams do most of the footwork on this stage, therapists can progress treatment more quickly.
Next, the therapist gently guides the client toward reconceptualization. In this stage of cognitive behavioral therapy, the client learns to reframe their behaviors as a series of thought patterns. One does not imbibe drugs and alcohol without reason, so the therapist must get to the true root of the issue. This stage effectively puts the “C” in “CBT,” allowing clients to better understand the processes of their own minds. A mixture of one-on-one sessions, group therapy sessions and written homework exercises will often characterize this stage. The goal is not simply to understand the client’s thought patterns, but to use that information in order to effect change. In fact, as WebMD notes, the change is considered vastly more important than the understanding:
“CBT is based on two specific tasks: cognitive restructuring, in which the therapist and patient work together to change thinking patterns, and behavioral activation—in which patients learn to overcome obstacles to participating in enjoyable activities. CBT focuses on the immediate present: what and how a person thinks more than why a person thinks that way.”
Upon reaching an understanding of the core cognitive issues at play and working to change them, the therapist begins implementing the aforementioned behavioral activation stages—skills acquisition and skills consolidation. Closely linked, these stages help the client to identify healthy behaviors that will help them meet their goals. In the case of addiction, such skills often include personalized relapse prevention methods. However, these stages also allow the client to develop skills and identify activities that will imbue their recovery with greater meaning. And since many addicts and alcoholics suffer from co-occurring mental and emotional disorders, the therapist will also work on helping the client to develop skills that may combat their depression, anxiety, PTSD or whatever else may play a hand in driving their substance abuse. Homework in this stage may often take the form of behavioral experiments rather than written assignments.
The next stages involve maintenance and follow-up. In the case of addiction treatment, the therapist may help the client develop a thorough relapse prevention plan and follow up with them in a few weeks to ensure their continued growth in recovery.
Primary Benefits Associated with CBT
Many benefits of cognitive behavioral therapy are written right into its methods. Take, for instance, its goal-oriented focus. Right off the bat, clients know which issues they need to address. Over the course of therapy, they may identify new issues in their thinking and behaviors that require attention. But with the time already spent on reconceptualization and skills development, they already know the process. This allows the client and their therapist to more efficiently address new issues as they arise.
Efficiency constitutes another primary benefit of cognitive behavioral therapy. After leaving treatment, clients may only require a few weeks of therapy with an outside source to address the goals they set for their recovery. As noted on WebMD:
“It takes about eight weeks for the patient to become competent at the skills that are being taught in therapy and to reasonably understand the model. While this is going on, the patient usually experiences a significant reduction of symptoms. Between eight and 12 weeks patients often experience a remission of symptoms. During the remaining time, they continue to practice the skills learned and to address issues related to ending the sessions.”
Some will feel they’ve done all they can in this time, and will focus solely on maintenance moving forward. Others will choose to continue therapy to focus on other issues. These may include co-occurring disorders, character defects or mere personal issues only tangentially related to recovery. No matter what the client chooses, CBT allows them to utilize their time effectively to ensure radical change in a timely manner. And their introduction to CBT in treatment enables them to more easily work with a new therapist upon leaving.
On the subject of therapists, CBT offers social benefits as well. Cognitive behavioral therapy requires a strong professional rapport between the therapist and the client. Over the course of their sessions together, the client will learn to trust their therapist without question. They can then apply this trust to other members of their support network, allowing them to achieve a greater level of authenticity within their social circle. Group sessions further enhance this benefit by allowing the client to become comfortable opening up in front of their peers early on.
Of course, the most important benefit of cognitive behavioral therapy might simply be its effectiveness. We see this especially in the case of co-occurring disorders such as depression. According to a 2012 article by the BBC, as many as 66% of individuals who take anti-depressants report limited results. However, studies show that as many as 50% can benefit from cognitive behavioral therapy. Interestingly enough, anti-depressants did work better when administered to patients who also received CBT. According to Professor Chris Williams, a member of the team whose research the BBC reviewed:
“The research used a CBT intervention alongside treatment with anti-depressants. It confirms how these approaches—the psychological and physical—can complement each other.
It was also encouraging because we found the approach worked to good effect across a wide range of people of different ages and living in a variety of settings.”
The wide demographic reach proves intriguing. One might attribute this to CBT’s increased focus on the present. Rather than simply reliving old traumas, clients learn to focus on how those traumas affect them today. This streamlines the psychotherapeutic process by immediately acknowledging the problem and swiftly moving toward results. When focusing on the past, demographic variations play a prominent role, as they may affect the client’s psychosocial development. The therapist must then reach an understanding not only of the person in front of them, but also how that person came to grow from the person they were in former years. But when focusing on the present, the therapist must only focus on the person they know in the here and now. Because at the end of the day, that is the person who needs their help.
Finally, as mentioned above, cognitive behavioral therapy allows for the implementation of numerous other therapeutic methods. While some therapists use a relatively straightforward format, they can adjust this as needed. Depending upon the individual circumstances of the client, a therapist may use such unique therapeutic methods as role-playing, psychodrama, Socratic dialogues, mindful breathing exercises or experiential therapy. This keeps sessions from going stale, and opens the client up to a world of supplemental tools to assist in their personal growth and development.
Undergoing CBT at New England RAW
At New England RAW, the bulk of your cognitive behavioral therapy will take place in group settings. This offers all of the primary benefits associated with CBT, while doubling down on the development of social authenticity. For those who experience difficulties when opening up in front of their peers, however, you will still have access to individual meetings with your therapist.
We should note that RAW also prides ourselves on offering a wide variety of holistic care options. Given the complementary relationship between CPT and other therapeutic interventions, this eclectic treatment programming offers great benefits. Furthermore, our diverse range of services allows for greater individualization of treatment, allowing us to treat each client in the manner that best suits their recovery. We see this especially when allowing our clients to engage in experiential and adventure therapy. Since this particular form of therapy often relies on teamwork and social interaction, clients can take the skills they learn in cognitive behavioral therapy and apply them in real-world settings. As they grow in their recovery, they receive consistent opportunities to assess their progress and adjust as needed.
Many treatment centers employ the use of cognitive behavioral therapy, but not all take advantage of its open-ended possibilities. While our primary goal remains the treatment of chemical dependence and co-occurring disorders, we endeavor to offer more than that. We strive to offer endless opportunities for growth, and the acquisition of skills that will enable clients to continue their journey of personal development long after they graduate treatment.
If you seek a path to recovery that allows you to discover the true depths of your better self, contact RAW today for more information on our programs. Those who seek a dual diagnosis program offering flexibility, individualization and a diversity of services will not be disappointed.