Cognitive behavioral therapy in drug treatment is the most common type of therapy in drug rehab; it can be used in group therapy and individual therapy.Cognitive behavioral therapy (CBT), when used in drug treatment, is based on the idea that feelings and behaviors are caused by a person’s thoughts, not on outside circumstances and events.
People are not always able to change their circumstances but, CBT says, they can change their thoughts thus changing how they feel and behave. As for drug addicts, this therapeutic approach brings awareness the way they behaved and felt when using drugs and alcohol. With cognitive behavioral therapy in drug treatment, they can change these destructive behaviors and develop new, healthy ones.
Cognitive Behavioral Therapy in Drug Treatment: What is CBT?
Cognitive behavioral therapy (CBT) refers to behavior therapy, cognitive therapy, and therapy based upon a combination of basic behavioral and cognitive principles. It is a “structured, short-term, present-oriented psychotherapy for depression, directed toward solving current problems and modifying dysfunctional (inaccurate and/or unhelpful) thinking and behavior.”
CBT has been shown to be effective in treating a variety of conditions, including mood, personality, eating, substance abuse, and psychotic disorders. Evidence-based treatment, where specific treatments for symptom-based diagnoses are recommended, has favored CBT over other approaches such as psychodynamic treatments.
Cognitive Behavioral Therapy in Drug Treatment: Mood Disorders
It’s quite common for people who struggle with substance use disorders, such as addiction, to also be suffering with mental illness, such as a mood disorder (i.e. depression, anxiety). Therefore, the most successful programs offer dual diagnosis treatment. Dual diagnosis treatment approaches treating the client for both of their conditions simultaneously for the best treatment outcomes.
Because CBT is useful in treating clients when it comes to addiction as well as those with mood disorder, cognitive behavioral therapy in drug treatment for those with a dual diagnosis is a valid, beneficial and therefore often-used approach.
Most therapists working with patients dealing with anxiety and depression use a blend of cognitive and behavioral therapy. This technique acknowledges that there may be behaviors that cannot be controlled through rational thought, but rather emerge based on prior conditioning from the environment and other external and/or internal stimuli.
Mainstream cognitive behavioral therapy assumes that changing maladaptive thinking leads to change in affect and behavior as well as emphasizes changes in the client’s relationship to maladaptive thinking rather than changes in thinking itself. Therapists use CBT techniques to help clients challenge their patterns and beliefs and replace what they call “errors in thinking such as overgeneralizing, magnifying negatives, minimizing positives and catastrophizing” with “more realistic and effective thoughts, thus decreasing emotional distress and self-defeating behavior.”
Modern Cognitive Behavioral Therapy in Drug Treatment
Modern forms of CBT include a number of diverse but related techniques such as exposure therapy, stress inoculation training, cognitive processing therapy, cognitive therapy, relaxation training, dialectical behavior therapy, and acceptance and commitment therapy. Some practitioners promote a form of mindful cognitive therapy which includes a greater emphasis on self-awareness as part of the therapeutic process.
Cognitive behavioral therapy in drug treatment has six phases:
- Assessment or psychological assessment;
- Skills acquisition;
- Skills consolidation and application training;
- Generalization and maintenance;
- Post-treatment assessment follow-up.
CBT is “problem focused,” meaning that it is used to address specific problems as well as “action oriented” – the CBT therapist assists the client in creating specific strategies in order to address the identified problems.
If you are struggling with a psychological disorder and/or substance use disorder, CBT and dual diagnosis treatment can get you on the path to health and recovery. At Palm Partners, we employ CBT methods as well as several other approaches to treatment, including holistic methods, in order to help our clients reach successful outcomes of their cognitive behavioral therapy in drug treatment program. Please call toll-free 1-800-951-6135 to speak with one of our knowledgeable and compassionate Addiction Specialists; we are available 24/7.
By Cheryl Steinberg
Everyone experiences a bad night’s sleep from sleep from time to time, you know, those nights when you lie awake for hours trying desperately to go to sleep but can’t. And then you start worrying about how little sleep you’ll get if you fall asleep now or…now; and how awful you’re going to feel tomorrow.
In fact, one-third of the world’s population experience short-term sleeping difficulties. These usually last only a few weeks. But for an unlucky few, these sleep disturbances may last a lot longer and lead to a diagnosis of insomnia.
Insomnia is described as a person’s inability to fall asleep, stay asleep, and/or else wakes up too early at least three times a week for at least three months.
Insomniacs experience persistent tiredness, low energy and difficulties with concentration, attention and memory. They may feel down, stressed or anxious, not only about getting a good night’s sleep but about their ability to do their daily activities.
How Do You Treat Insomnia?
If you are experiencing insomnia, a visit to your doctor might only result in getting a prescription for sleeping pills. But sleeping medications are just a Band-Aid, only providing short-term relief. Furthermore, they can be harmful and are often times highly addictive. For people in recovery from drugs, medications like Ambien are risky.
The good news is that there are other ways to treat insomnia, without the use of these powerful medications. Successful treatment of insomnia requires creating new, healthy sleep habits.
Here are 7 ways to treat insomnia.
#1. Establish a relaxing bedtime routine
Maybe it’s drinking warm milk or a hot cup of tea, or maybe a hot shower and some yoga. Get in the habit of doing things that help you relax and get in sleep mode.
#2. Limit the use of smart devices before bed
Also, using your smart phone or tablet before bed can interrupt your circadian rhythms, which regulate your sleep cycle. Smart phones and even flat screen televisions emit blue light, which is basically translated as daylight by your body, thus your body thinks it’s time to stay up even though it’s now one in the morning and you’re trying to fall asleep.
#3. Keep work and sleep spaces separate
And refrain from using these devices in bed. If you mix your work space with your sleep space, that is, using your bed for both, when you try to fall asleep, your body gets mixed signals about what it’s supposed to be doing: working or sleeping.
#4. Don’t fight your insomnia
If you can’t sleep, don’t stay in bed, tossing and turning and getting more frustrated. Instead, get up and do a relaxing activity, such as reading a book. Go back to bed only when you feel sleepy again.
#5. Web-based treatment
Another credible alternative is web-based treatment. Research from Japan to America shows that, for some people, online insomnia treatment modules may be as effective as visiting a health professional in person. Online programs can help you to practice good sleep hygiene habits, change unhelpful sleeping patterns and reduce the worry that can contribute to insomnia, helping you to get a better night’s sleep.
#6. Exercise regularly
Regular exercise has a bunch of health benefits – too many to name here. But, when it comes to insomnia, getting into a regular exercise routine can help. Besides getting your body to work at its optimum level, it also basically tires you out come evening time.
#7. Talk to your therapist
If you’re still having trouble despite trying all of the things mentioned above, then consider talking to a therapist. Cognitive Behavioral Therapy (CBT) has been found to reduce sleeping difficulties by 50% on average, and reduces insomnia symptoms to a level where they are no longer considered clinically severe.
The way CBT works is that it re-trains people to view the bedroom as a place of sleeping instead of a place where they lie awake tossing and turning and worrying about not sleeping. CBT also helps people change their lifestyle and sleeping environment, learn relaxation skills and challenge the unhelpful worries and beliefs that contribute to insomnia.
Got a lot on your mind? Have become physically dependent on drugs, even sleeping pills, and are still suffering from insomnia. It’s hard falling asleep with the weight of the world on your shoulders. Once you admit that there’s a problem for which you need help, the rest is easy. Call toll-free 1-800-951-6135 to speak with an Addiction Specialist today.
By Cheryl Steinberg
As much as 90% of the drug and alcohol rehabs in America endorse the 12 Step approach to treatment and recovery and yet, research shows that there’s a better way: combining therapy and medication.
If you are a member of a 12 Step fellowship, you might know quite well the bias against the use of medications in recovery – and I’m not talking about narcotics. I mean things like antidepressants and medications designed to support abstinence, such as opioid blockers. The FDA has approved two different medications for use in the treatment of an alcohol use disorder.
So what are these FDA-approved medications and how effective are they?
The first medication is called acamprosate (brand name Campral) and it has been used for alcohol use disorder treatment since the 1980s in Europe; it was accepted by the FDA in 2004. The way Campral works is this: it stabilizes the initial depression as well as reducing cravings by quieting the feelings of being restless, irritability, and discontent that alcoholics experience when they first quit drinking. Acamprosate is meant to be taken daily for the first 12 months of abstinence.
The second medication is Naltrexone. Although Naltrexone is an opioid inhibitor, is has been FDA approved as a daily medication to be taken at a low dose for the treatment of alcohol abuse. Naltrexone is best if used as an emergency relapse drug. Alcoholics who take it prior to a relapse have reported significantly less negative impact of their relapse. For those who want to be abstinent, naltrexone works as a great emergency relapse drug in combination with acamprosate.
It also functions as a supplement to be taken prior to a planned drink. In fact, naltrexone works so well to reduce relapse that many alcoholics use it to successfully drink on a regular basis with very few reports of high binge drinking. Therefore, it might be entirely possible in the near future for alcoholics to simply carry a bottle of naltrexone with them for drinking occasions instead of attending an AA meeting when the urge to drink hits.
Putting It Into Perspective
If you think of these drugs being used to treat an ongoing disease like asthma, which alcoholism is, then it might make more sense. So, in this example, consider that the majority of asthma sufferers have both a daily inhaler and an emergency inhaler. Therefore, for people with alcohol use disorder, acamprosate is their daily medication and naltrexone is their emergency relapse drug.
Epidemiological Studies and Findings
Currently, clinical trials show that the combination of acamprosate, naltrexone, and cognitive-behavioral therapy have the highest rates of recovery of any system used in drug and alcohol treatment. In fact, this conglomeration of treatment approaches has been studied thoroughly over the past 10 years, revealing abstinence rates of greater than 65%. No other program, not Alcoholics Anonymous, nor SMART Recovery®, comes close to producing these rates of abstinence, and yet very few treatment programs in the U.S. are engaging in this practice.
Treating Nicotine Addiction: A Case for Medication
Abstinence rates for nicotine are at an all-time high of 82% in the United States according to the CDC. Nicotine addiction treatment has been the only drug treatment program to have significantly impacted drug use in recorded history.
So what’s happening in nicotine addiction treatment that isn’t happening in the drug rehabilitation industry?
The answer is pharmacological assistance in quitting addiction, which is to say, involving the use of medication(s) as a vital part in helping people overcome their addiction. First of all, it’s now widely known that nicotine is one of most addictive drugs in existence. Considering just how addictive this drug is, how then have smoking rates decreased so dramatically?
The answer to that is this: the use of a medical-psycho-social model of recovery. A comprehensive study from the Western Journal of Medicine in 2002 made two conclusions after scrutinizing over 6,000 articles on nicotine cessation. The first conclusion was that taking FDA-approved medication for the cessation of nicotine more than doubled success at quitting smoking. The second was that the likelihood of successfully quitting increased even further when anti-smoking medication was combined with evidence-based therapy for behavioral modification, such as cognitive behavioral therapy (CBT).
There is no study that exists showing that therapy or 12-step programs alone are as effective as a combined therapy and medication program. Knowing this, it’s safe to say that any program that does not prepare recovering alcoholics with the tools of both therapy and anti-addiction medication that can lessen the impact of a relapse is unrealistic and negligent.
Consider this: of those who are attempting life-long abstinence, over 99% will drink at least once within a 20-year period. Therefore, healthcare practitioners are ethically responsible to prepare their patients with alcohol use disorder by providing them with essential information on how to mitigate relapse if it occurs.
Are you seeking recovery for an alcohol or drug addiction? Do you need help finding out where and how to start? Our Addiction Specialists are available around the clock to take your calls and answer your questions. Let us help you. You are not alone.
Author: Justin Mckibben
In most drug and alcohol treatment centers the use of Adderall and Ritalin are prohibited, so how do clients who truly suffer from Attention Deficit Hyperactivity Disorder, commonly referred to as ADHD, deal with their symptoms while in recovery? The question is a pretty relevant one, because a lot of young people especially deal with this dilemma in early recovery. Many individuals have been diagnosed with ADHD since they were children, and have even been prescribed stimulant medications to combat the symptoms, such as Adderall.
Upon choosing to commit themselves to treatment in a residential inpatient substance abuse rehab program, many will be concerned with the expectation that that have to stop taking any stimulant drug they may have been prescribed for their ADHD.
The Concern with Substitution
For an addict, the idea of relying on a substance is a scary but, but some persist that it is necessary while others contest that without giving up all substances they will not have a successful recovery. A stimulant addiction is especially difficult when trying to make progress out of the stages of drug dependence when you are still taking some form of stimulant. Adderall falls into the same class of drugs as cocaine, methamphetamines, and other amphetamines. Basically, Adderall is suspected to contribute to the chemical dependency for a stimulant addict.
Some would insist that the only way to consider an addict clean is them having none of the Adderall in their system. This side of the argument states that recovery is only possible when the individual does not rely on habit forming and mind or mood altering medications or other substances; it is more of a ‘purist’ ideal. The problem is, the addict would now face the trial of trying to get acclimated with ADHD without medication, and what are the best methods of trying to cope with the symptoms of ADHD while sober?
When taking into consideration the ideas from a more ‘purist’ recovery point of view there are some factors that are consistently true. Some of the most important work in rehab for the recovering addict is to learn new and more effective coping skills and healthy strategies for managing their life and their behaviors. The ‘purist’ recovering addict would most likely include addressing ADHD without the medication the individual may have relied on for years as part of the recovery process. Issues like being unable to focus or having an increasingly difficult time trying to listen, if the person is restless and cannot manage to keep calm or still, or even developing outbursts of anger and they are constantly distracted, are expected to be dealt with by means of any method other than using medications that curb the behavior chemically.
Methods without Medications
- Cognitive Behavioral Therapy (CBT)
CBT in particular is one form of a behavioral intervention which addresses specific thought patterns and behavioral habits. Self-management skills are important for everyone to learn, especially addicts and alcoholics in recovery. However this can prove extremely difficult for those with ADHD because this mental health issue is infamous for the inability to control one’s own thought processes. CBT introduces various ways to approach situations differently while encouraging healthier habits.
As an addict of alcoholic with ADHD, making better choices in our diet and eating habits can actually help reduce many of the inconvenient symptoms and clear the mind so that application of other therapy such as CBT can become more effective. With a chemical imbalance, our food has a substantial impact on how our mind and body will operate.
With an indistinct depiction of where an individual’s brain has abnormal functioning, therapists have a greater advantage with how to assist recovering addicts and alcoholics with new ways to rehabilitate the brain, creating new reactions that help them to stay calm and focused in otherwise troublesome situations. The most effective and positive form of treating ADHD without Adderall or other stimulant medications in recovering addicts is the combination of behavioral techniques, healthy diet, and neuro-feedback.
Dual Diagnosis ADHD
Dual diagnosis also affects millions of other people working to deal with ADHD in recovery. A co-occurring disorder is dominantly present in many cases of adults with ADHD, and recovering addicts will often suffer from another mental illness such as:
- Personality disorder
- Eating disorder (anorexia, bulimia, overeating)
Dual diagnosis programs are typically set up to include helping recovering addicts to heal from the symptoms of two or more disorders simultaneously. So when someone who is an addict with ADHD and another disorder is trying to attempt recovery without a stimulant medication, the fact that symptoms can sometimes be very much the same for both disorders must also be taken into consideration when trying to figure out what steps to take to cope with ADHD.
Although it is true that Adderall is a stimulant and a medication that some would say is too dangerous to risk using to control ADHD, other opinions outside the more ‘purist’ conception would say that as long as the medication is not abused, it is an outside issue. There are those who believe that as long as the individual has a genuine need for their medication, and consults with their sponsor in regards to a 12 Step program, then the decision is between the person and their doctor. They may still agree that it is a risky situation and should be taken into serious consideration, but many of us recovering addicts and alcoholics in the rooms of recovery are not doctors and have no authority to tell another addict what to do, that is up to their physician.
That being said, there are alternative forms of maintenance, so it is probably best to explore other options to help address an addicts issues with ADHD. Stimulants like Adderall are very dangerous, and they do have addictive chemicals and long term damaging effects, so continued health and sobriety may depend on getting off these kinds of medications as quickly as possible and developing new coping skills. Some people do develop addictions to their ADHD medications, and abuse them by justifying it with their disorder, so being self-aware will also help you to decide the best course of action once you realize how much you truly depend on those stimulants to keep yourself sick.
ADHD and other mental health disorders can complicate the idea of recovery, but there is a way to safely and effectively recover from addiction or alcoholism and live a happy and productive life without dependence on medication to alleviate the issues created by ADHD. Getting free of drugs and alcohol does not mean having to take on all the stress of your disorder alone, there is help out there from people who have gone through it and come out the other side more alive than ever. If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135