Technology may provide a means for CBT interventions to circumvent the ‘implementation cliff’ in Stages 3–5 by offering a flexible, low-cost, standardized means of disseminating CBT in a range of novel settings and populations. Moreover, returning to Stage 1 to reconnect clinical applications of CBT to recent developments in cognitive science and neuroscience holds great promise for accelerating understanding of mechanisms of action. It is critical that CBT not be considered as a static intervention, but rather one that constantly evolves and is refined through the Stage model until the field achieves a maximally powerful intervention that addresses core features of the addictions. CBT for substance use disorders captures a broad range of behavioral treatments including those targeting operant learning processes, motivational barriers to improvement, and traditional variety of other cognitive-behavioral interventions. Overall, these interventions have demonstrated efficacy in controlled trials and may be combined with each other or with pharmacotherapy to provide more robust outcomes.
Quality of the Evidence
- Significantly more participants in clinician-delivered treatment (44.8%) and TES (46.7%) were abstinent at the end of treatment compared with the 2-session brief treatment (12.5%).
- You will continue gambling, even in the face of negative social, financial, or legal consequences.
- By targeting these maladaptive thoughts, CBT helps patients develop healthier coping mechanisms and find alternative ways to manage stress and triggers without turning to substances.
Uptake of the computerized intervention was weak, with only 63% of those assigned to this condition accessing a module, and rates of 3-month follow-up were modest across conditions (57% of those in waitlist control and 48% of those assigned to computerized intervention). As standard outcomes (urinalyses or self-reported days of amphetamine use) were not reported, it was difficult to draw conclusions regarding the efficacy of the intervention in this sample. Cognitive Behavioral Therapy One outcome of the Blending Initiative was the inception of the Clinical Trials Network (CTN), a 17 site regional research and training center which collaborates with many community treatment programs to study the effectiveness of specific interventions in diverse community settings and patient populations.
Lifestyle changes
Participants have reported improved emotional regulation and reduced cravings, which translates into lower relapse rates over time. These findings underscore CBT’s comprehensive approach, emphasizing the need for continued practice of skills learned during sessions. Others are more ambivalent, and may waver in their willingness to take part in treatment. Similarly, patients who are uncertain about giving up drinking and drugging may present for treatment with the goal of “cutting back” on alcohol and other drugs. Such patients may disagree that they will need to eliminate their use of psychoactive chemicals, and may decide to leave therapy if the therapist insists that the goal must be abstinence.
Data Extraction and Coding
CBT is one of the most prevalently used psychotherapeutic approaches which focuses on understanding how individual’s thoughts, emotions and behaviours are all interconnected and affect one another (Beck, 1993). The main principles of CBT are rooted in analysing an individual’s mental processes to understand and alter negative and maladaptive thought patterns. CBT suggests that, thoughts, emotions and behaviours are all interconnected and individuals develop maladaptive thinking patterns based on the negative experiences they have experienced, which lead to the development of numerous psychological disorders. CBT has been subject to extensive research and the results have established its efficacy in addressing numerous mental health disorders, such as depression, anxiety, post-traumatic stress disorder and SUDs (McHugh et al., 2010).
The evaluation of CBT for SUDs in special populations such as those diagnosed with other Axis I disorders (i.e., dual diagnosis), pregnant women, and incarcerated individuals is beyond the scope of the current review, and thus the descriptions provided below focus on SUD treatment specifically. In essence, CBT is an empirically supported, well-founded and widely recognized psychotherapy approach that been effective in addressing a broad range of mental health disorders, including SUDs (Hides, Carroll et al., 2010). The efficacy of CBT has been strengthened by integrating recent technological interventions with the aim of improving the efficacy of the outcomes of treatment and providing individuals extra guidance and resources as they progress through their recovery journey. Cognitive behaviour therapy (CBT) is a structured, time limited, evidence based psychological therapy for a wide range of emotional and behavioural disorders, including addictive behaviours1,2. CBT belongs to a family of interventions that are focused on the identification and modification of dysfunctional cognitions in order to modify negative emotions and behaviours. Although the effects of an intervention on functional outcomes are a consideration when providing an overall treatment recommendation, we chose to only include quantitative reviews that reported substance use outcomes.