Talk therapy (also called psychotherapy) is now widely considered by psychiatric professionals and policymakers alike to be a pillar of substance use disorder (SUD) management and treatment. Together with medication-assisted therapy (MAT) and medically supervised detox, talk therapy is one of the approaches most likely employed on Americans attempting SUD recovery today.
When talk therapy is discussed in the context of SUD or behavioral addiction treatment, chances are that the approach employed will be cognitive-behavioral therapy (CBT) or one of its many derivatives. While CBT is not the only type of talk therapy used for treating and managing SUD, it is the most widely used by American addiction treatment specialists, including those in the Dallas drug rehabilitation system.
Below, we’ll explain what CBT involves, and why it’s widely used for SUD.
CBT or cognitive-behavioral therapy is a psychotherapy approach where the therapist attempts to guide the patient into changing maladaptive thinking patterns and replace them with constructive, positive ones. The basic idea is that good thinking patterns enable good behavior and vice versa.
The approach assumes that the patient is, at least, capable of a fair level of emotional regulation and has their cognitive functioning mostly intact. Individuals who are still in the early stages of recovery are typically not considered for CBT until their condition is somewhat stable. Patients who have difficulty controlling their emotions or have limited cognitive ability may undergo other types of talk therapy before they are receptive to standard CBT.
CBT, while generally following a more-or-less standard approach, can be implemented in several ways. The Socratic method of leading the patient through questions is the most common way this is done, though it isn’t the only method by any means. CBT in the context of addiction treatment is usually focused on helping the individual deal with cravings, triggers, and negative thoughts that lead to more of the undesired behaviors.
SUD is often linked to other psychiatric conditions like trauma, anxiety, paranoia, and depression, either as a cause or a contributor. These conditions can lead to negative thinking, which in turn leads to maladaptive behavior such as drug use. As with the substance misuse itself, negative thoughts often come as part of a self-reinforcing pattern, which makes them difficult to suppress without intervention.
When left unmanaged, these negative thought patterns can continue to persist well after the individual has detoxed from their substance of choice. Even if they manage to stay off drugs and make a partial recovery, remaining negative thought patterns continue to make them vulnerable to future relapses.
As mentioned earlier, these can arise directly or indirectly as a result of continued substance misuse. However, existing traumas and psychiatric conditions like depression can also leave a person vulnerable to using drugs and alcohol. When they do, this leads to a situation called a dual diagnosis which can further complicate their recovery.
Traumatic experiences are widely considered to be the leading cause of these psychiatric issues. These are more common in dysfunctional households as well as in occupations that are emotionally taxing. They can be caused by continuous mildly negative experiences as well as serious one-time events.
Negative thought patterns can happen at any stage in one’s lifetime. However, they are more likely to start in childhood and adolescence, possibly due to the brain still being especially plastic and changeable at these stages. Notably, these are also the ages most people with substance use disorders start to misuse substances.
As mentioned earlier, CBT is usually applied once the patient is stable and able to regulate their emotions. It will not necessarily help at the earliest parts of recovery, where detoxification or medication-assisted therapy are initially applied. Rather, it tends to be more useful at helping recovering individuals stay clean.
CBT can be applied to help the patient with their motivation, help them better deal with drug use triggers, as well as help control underlying issues like anxiety and depression. It could be applied in both a group or individual setting and paired with other psychotherapy approaches, making it a flexible tool for SUD treatment specialists.
It’s important to note that you should not attempt any psychotherapy approaches on yourself without the close guidance of a qualified professional. While the risks are relatively low, there can be some hard resulting from misapplied CBT, which can make future recovery more difficult.
If you’re in North Texas, Dallas Drug Treatment Centers can give you a comprehensive listing of programs and treatment professionals experienced in the application of CBT and other talk therapy approaches. Good luck, and stay sober!