Cognitive Behaviour Therapy for Addiction (AQA A Level Psychology): Revision Note

Cognitive behaviour therapy to treat addiction

• Cognitive behavioural therapy (CBT) is an attempt to change the faulty thinking of an individual who uses drugs or engages in another behaviour as a maladaptive way of coping

• If CBT is successful, then these faulty thoughts are replaced with more adaptive ways of thinking through functional analysis, e.g.,

  • The client and therapist together identify high-risk situations that increase the likelihood that the client will engage in the addictive behaviour

  • The therapist then challenges the client's cognitive distortions

• CBT is used to develop coping skills, strategies and the strength necessary to deal with addiction-related cues or triggers, including:

  • Drug-refusal skills – therapy equipping individuals with specific strategies so that they can deal with the physical temptation and the social pressures to take drugs

  • Cognitive restructuring – this requires the individual to examine the thought processes that precede their addictive behaviour and, with the help of the therapist, replace these with alternative thought patterns that do not end in reverting to the addictive behaviour

  • Relapse prevention training – a more long-term technique of preventing a return to addictive behaviour by supporting the individual’s new thought patterns and focusing on giving them control over their addiction

• Part of CBT is also teaching more general skills, like problem-solving, assertiveness and relaxation, all of which are aimed at relapse prevention

Research which investigates cognitive behaviour therapy

• Carroll et al. (1994) found that the skills individuals learned through CBT for  relapse prevention remained after the therapy ended, suggesting that CBT is an effective therapy for addiction

• Petry et al. (2006) found that pathological gamblers attending Gamblers Anonymous (GA) meetings and receiving CBT were gambling significantly less than participants attending GA meetings only, suggesting that CBT is an effective therapy for gambling addicts

Evaluation of cognitive behaviour therapy

Strengths

• CBT avoids the ethical issues associated with aversion therapy, such as making someone sick or distressed, meaning that individuals are likely to continue with the treatment

• CBT is effective at preventing relapse, as the cause of the individual's addiction is dealt with rather than merely the symptoms, unlike drug therapy, suggesting that CBT is an effective therapy

Limitations

• Cuijpers et al. (2008) argue that drop-out rates for CBT can be higher than other forms of therapy, as over time individuals may lose motivation and complete fewer homework assignments and attend fewer sessions

  • This means that it is difficult to understand how effective CBT is for reducing addictions

• CBT uses a wide variety of techniques and can be delivered online or with telephone support without the presence of a therapist

  • This flexibility and variety of use means that it is difficult to pinpoint exactly which elements of CBT are most useful in reducing addictions

Issues & Debates

• CBT is based on the idea that individuals have control over their thoughts and behaviours, supporting the free will side of the determinism vs free will debate

  • This contrasts with deterministic models (e.g. biological or learning theories) that suggest addiction is outside of conscious control

• CBT offers a more holistic approach by addressing both cognitive and behavioural aspects of addiction

  • This contrasts with biological therapies, which are reductionist and focus only on brain chemistry or genetics