Cognitive Behavioral Therapy

Therapy for some addictions begins with a trip to the pharmacy. By offering replacement medications or soothing therapies, some mental health experts hope to allow their clients to overcome crushing cravings that can keep them using and abusing drugs, even when they no longer want to do so. But not all therapies involve pharmacies. In fact, some of the most powerful weapons experts can use in the fight against addiction don’t involve medications at all. Cognitive behavioral therapy (CBT) is one of these therapies.

CBT Basics

CBT got its start in the 1960s, when a psychiatrist determined that some patients tended to have internal thoughts that they did not share during their therapy sessions, even though those thoughts had a deep impact on the way people behaved. According to an in-depth article produced by Psych Central, this psychiatrist, Aaron Beck, decided to develop a form of therapy in which clients could get in touch with the thoughts that drove their behavior, and once these clients changed their thoughts, they could change the way they acted.

The contents of the treatment sessions can vary dramatically, depending on the mental illness at play, but there are some generalized rules that apply in most cases.

For example, CBT sessions are typically run by mental health professionals, such as licensed social workers, psychiatrists or counselors, but clients have a significant and profound role to play as therapy moves forward. They’re expected to participate in the development of the treatment program, and they’re asked to give feedback at the beginning of each session about how well the previous session helped. Clients are also expected to do a lot of homework between sessions.

Pros and Cons

Many studies suggest that CBT can be a helpful therapy for people dealing with very serious mental illnesses. For example, in the Substance Abuse and Mental Health Services Administration’s National Registry of Evidence-Based Programs and Practices, CBT is listed as an effective therapy for people who have depression and anxiety disorders. The treatment has been proven so effective for people like this, in part, because people report feeling remarkably better in a variety of different ways when the treatment is through. They can solve problems with ease, for example, and they can sleep soundly. They can also deal with stressful situations and handle their family issues. In general, they just seem better.

Reports like this might make anyone want to run to the clinic and ask for CBT, but there are some people who feel that the therapy isn’t quite right for everyone. For example, CBT tends to be a short-term therapy that focuses on goals and tasks. People are encouraged to move quickly and change radically, and they’re then encouraged to leave the program with equal speed. Some people just need a little more time to make decisions, and they may feel like the fast pace leaves them with little time for quiet reflection and growth. They may also feel as though they’re being pushed to do things they’re not quite ready for.

There are alternate forms of CBT that might be helpful for people like this. Dialectical behavior therapy (DBT), for example, tends to move at a slower pace, and the therapist attempts to support and encourage, not push and challenge. Some people might prefer this kind of therapy more than they’d like standard CBT.

Additionally, some people feel as though CBT’s relentless focus on the future gives them fewer opportunities to think about the past, including the relationships that may have been marred by mental illness and addiction. Standard psychotherapy might be better for people like this, as they’ll have the time to talk and to learn. Family therapies might also be helpful for people like this, as they’ll have the chance to work within the realm of the family as they heal. Even standard addiction education might be helpful for some people, as this form of therapy allows people to understand how addictive substances work inside the human body and why they can be so dangerous.

At Axis, we believe in providing customized care for everyone we treat. Some of our clients benefit from CBT therapies, and we work with them to help them to understand their thoughts and their choices. Some of our clients are more cerebral, however, and they enjoy participating in educational sessions. Still other clients just don’t feel well unless they’re in the company of their families, and we work with them on family-based therapies. Whatever we need to do to help clients, we’re willing to do. We hope you’ll call us, and we can tell you more about our approach.