Cognitive Behavioural Therapy (CBT )

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What Is Cognitive Behavioural Therapy?

Cognitive Behavioural Therapy CBT is a form of talking therapy that helps one mange their problems by changing how they think and behave.

This form of therapy is used to treat depression and anxiety and is useful for physical health problems as well as one's mental health. (1)

CBT can also work with:

  • Post traumatic stress disorder,
  • Obsessive compulsive disorder,
  • Anxiety disorders,
  • Mental health problems and
  • Eating disorders as well.

CBT is also a well-known therapy option used by doctors at drug and alcohol treatment facilities for the treatment of substance use disorders.

CBT is used in most clinics for stress management of drugs and alcohol as well as mental illness assessments and clinical trials.

Evidence from peer reviewed studies and other large scale trials support the efficacy of CBT in the treatment of drug and alcohol use disorders. (2)

The reason behind this is that; CBT works to change a person's belief system and stop the physical and psychological need for substances that are hazardous to health. (2)

CBT Aims

CBT aims during the therapy sessions is to get to the root course of the problem and to understand negative thinking and other unhelpful thoughts leading to various mental health issues.

Cognitive Behaviour Therapy - The Mind and Body in Therapy

Cognitive therapy is broken down into components such as; thoughts, perceptions, memories, and reasoning.

According to the CBT, Royal College of Psychiatrists and the national institute, CBT can be classified as follows; (3)

The C component of CBT is concerned with the mind.

The B of CBT means behaviour i.e. actions, attitude, and conduct.

The T behavioural component of CBT is concerned with the body.

Cognitive Therapy

Cognitive behavioural therapy is a structured therapy session, that deals with the link between cognitions, thoughts, behaviours, and actions.

One major component of being human is ‘free will’ that is; the choice to drink or to take drugs if one choses to, dependence removes this ‘free will’ and a want then becomes a need.

Underpinning this chemical dependence is a psychological one i.e. a thought and feeling that works in combination to say alcohol is needed, required and must be consumed immediately – to feel better.

Conditions such as:

  • Alcoholism,
  • Drug addiction,
  • Eating disorders,
  • Mental health problems,
  • Mood disorders,
  • Bipolar disorder,
  • Social anxiety,
  • Panic disorder,
  • Psychological distress from overwhelming problems,

Can all be connected to the brain. (4)

CBT And One's Beliefs

CBT will challenge this faulty belief system by addressing the situations, thoughts, feelings and ensuing behaviours. (5)

Situation

This could represent a bad day at work.

Thoughts

For example; the boss and colleagues don’t like me they think my work is poor

Feelings

This includes feeling of  Inferiority, paranoia, low self-worth.

Behaviours

This refers to ingesting alcohol or drugs to take the thoughts and feelings away.

The mind says you can’t cope the body says I know a way how. The pair work in synchronicity. The mind and body are interlinked when it comes to psychological issues.

Cognitive behavioural therapy CBT has therapeutic approaches considers the following four thought patterns.

Situation – A bad day at work

Consider: Was it actually a bad day at work? What was achieved? Did you complete the day and finish your work satisfactorily?

Thoughts – They don’t like me; my work is poor.

Consider: Do you have evidence to back this claim up? Perhaps they have tried to interact with you, and you have pushed them away many times – so they don’t get too close and find out your secret i.e. the addiction to drugs or alcohol.

Feelings – Inferiority, paranoia, low self-worth.

Consider: Address where these feelings are coming from? The secret that you are addicted to alcohol or drugs may incite these feelings.

Behaviours – Ingest alcohol or drugs

Consider: Will the problems disappear if you take alcohol or drugs? Or get worse?

Once all these points have been considered or looked at from a different point of view, the answers will show that drugs and alcohol are the problem and the elimination of these substances will improve work output, increase self-esteem and improve one's mental health. (5)

Cognitive Behavioural Therapy and Faulty Belief Systems

Loved ones shake their heads in despair asking, “What’s wrong with you?” “Why can’t you stop drinking?” This feeling of condemnation and hostility by well-intentioned loved ones only leads to a worsened mental health condition, and more drinking.

This is known as the phenomenon of alcoholism – why would such a person continue to drink despite all the signs pointing to stop?

In short alcohol dependence has occurred and alcohol is a mood- and mind-altering drug. Removal of the substance and a new clarity in thinking followed by CBT therapist sessions will work to change this vicious cycle. (5)

The Feelings And Emotions Component of CBT Treatments

Giving people coping skills for their emotions and the thoughts that trigger those emotions is an essential component of the exposure therapy in Cognitive Behavioural Therapy.

Feelings connected with cravings for drugs and alcohol are:

  • Low self-worth

  • Low self esteem

  • Inability to cope with daily life

  • Inability to conduct healthy relationships

  • Anger

  • Low mood

  • Hopelessness

  • Loneliness and Isolation

These feelings are strong and negative in nature the belief system that ‘one more’ of anything will remove them is faulty. There are helpful and unhelpful ways of dealing with these feelings.

Unfortunately, the coping mechanisms employed by addicts to get rid of these feelings are taking more and more alcohol or drugs.

CBT sessions are ideal for psychological treatment as they help get to the root cause of these feelings and how one can lead their everyday life without the need for alcohol and drugs. (6)

CBT and Negative Behaviours

Negative thoughts, feelings and emotions ultimately lead to negative behaviours.

Here are some negative behaviours:

  • Getting drunk at one's daughter’s birthday party

  • Getting high before driving

  • Getting drunk and high to go out socialising

  • Taking a small drink to get through work

  • Taking some drugs in order to stay awake at work

When considered together with interpersonal therapy, the general consensus is that these behaviours are not conducive to a happy and productive life.

To change thinking will change behaviours.

  • My daughter enjoys my company more when I am sober – I will stay sober at the party.

  • Being under the influence of alcohol or drugs is illegal – I believe in the justice system and do not want to injure others or myself whilst driving.

  • I really enjoy good music and conversation with friends if I stay drug and alcohol free, I will be able to enjoy myself and not feel guilty or ashamed the next morning.

  • It is against the contract I signed to go into work under the influence I have self-respect and want to keep my job it’s not OK to drink before work.

  • Drugs make my vision and actions impaired it is dangerous to use these substances at work I want to keep my job. I would be unhappy if my colleague was doing the same. (7)

After CBT, taking drugs and alcohol will cause one to feel worse. There are of course alternative treatments, such as antidepressant medication and other therapies, but talking treatments have the best results.

If you cannot attend a CBT therapy session, you could find a clinic that can offer online CBT, self help materials and computerised CBT.

CBT with a therapist at Abbeycare is a goal oriented approach that will consider negative behaviours attached to using alcohol and drugs and address these in a structured therapeutic environment conducive to the promotion of long-term recovery from alcohol and/or drugs. CBT works.

We also try to solve problems and any medical condition that is affected by one's present thoughts. Short term treatment is not always advisable. Call us today in order to find help. (7)

CBT in Abbeycare – The Therapeutic Approach 

The idea behind CBT is that it should be a collaborative effort, that is; the client has to have some understanding of what the approach is and how it can be useful to their sobriety. Then the therapist will jointly clarify what problem areas need addressing. A collaboration.

This creates an empowering atmosphere. Instead of feeling like the therapist is dictating the circumstances of the conversation the client will feel like they are an active participant.

Other Treatments

Other treatments seek to tell the client where they go wrong, but CBT gives both therapist and client and opportunity to discuss matters that make them feel worse about their lives and their need to drink more alcohol.

CBT therapy sessions are carried out by highly qualified CBT Therapists. You can get a referral from a doctor, health insurance plan, friend or other trusted source.

Most people ask how many sessions they need, but the sessions will vary according on the length of time a resident is at Abbeycare and if they wish to carry on sessions post rehab as part of their aftercare programme.

The Sessions

Sessions last between 45 minutes to 1 hour and handouts, links by emails or self-help books (may be handed out) are available.

In essence the client becomes their own therapist and learns how to apply CBT to themselves. Knowledge helps with the recovery process. And, once learned, CBT can be applied to many life situations, including the management of persistent chronic pain.

During the sessions, vicious cycles may be identified and learning how to break these up is effective to the participant of this therapy.

For example; continuing to use substances when many negative consequences continue to occur is a vicious cycle.

As a therapeutic programme delivered within Abbeycare, the therapists are trained in using an eclectic approach such as CBT, 12 Steps and Motivational Interviewing (MI) which are all designed to challenge negative core beliefs around the relationship with substances.

Goal Setting in CBT 

A major component of CBT is setting goals with the therapist. Goals are used to:

  • Reach clear expectations for you and what you want out of treatment.

  • Agree to specific goals to work on, collaboration, team building

  • Keep track of your progress, look back and see if you have improved, changed or achieved.

Some goals can be long term goals. Others can be short-term goals building towards a long-term goal.

Setting goals can be a difficult task. The participant can be asked the following questions: (8)

  • What do you want to happen?

  • What would you find rewarding? 

Frequently Asked Questions

Do I need to do CBT whilst in Abbeycare?

At Abbeycare an eclectic model is used when delivering the therapeutic programme. Residents are encouraged to participate in all aspects of the programme on offer. The therapists use this tried and tested model as it has been shown to promote long term recovery.

I’ve tried CBT before it didn’t work can I do something else?

At Abbeycare an open mind is required when approaching all parts of the programme. There may have been many reasons CBT never worked before, from duration of sessions to your commitment, at that time, to change. All participants are asked to do is try this model of therapy as this may be the right time for you.

How much does CBT cost?

CBT at Abbeycare is included in the price of rehab treatment. However, if you want to continue the sessions Post Rehab the price can be negotiated with Abbeycare as part of the CTI Continued Therapeutic Intervention programme that’s part of Aftercare. The prices are available on request.

I am on anti-depressants will CBT still work for me?

As CBT is a talking therapy therapist encourage the use of both. In many cases a combination of the anti-depressants used to treat the symptoms of low mood associated with depression and other mental health conditions and CBT used to treat the causes i.e. what brought about the low mood have proven successful.


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