When clients enter our residential rehabilitation programme, initial detoxification takes central stage. Detoxification must be completed so withdrawal symptoms can be observed and treated. As soon as withdrawal symptoms subside the psychological aspect of addiction is treated in counselling sessions. Cognitive Behavioural Therapy (CBT) is a major component of counselling used at Cassiobury Court. CBT is a form of psychotherapy. CBT is effective in treating all manner of addictions. Behavioural disorders such as depression and eating disorders are also effectively treated with CBT.
Cognitive Behavioural Therapy origins
CBT is the brain child of Aaron T. Beck, an American psychotherapist. CBT was conceived in the 1960s as a marriage between the otherwise distinctly separate schools of ‘cognitive’ and ‘behavioural’ therapy. CBT was initially designed to treat depression but it has since been used to treat a number of other mental illnesses, including addiction. Beck reasoned; people’s interpretation of events determines their responding behaviour more so than events themselves. We are shackled by the interpretation we have of events and our thoughts prevent us from deriving alternative meanings. Our response to events is ‘automatic’ and shaped by our interpretation to similar events occurring in the past. Beck termed this ‘automatic thoughts’. Such thoughts are capable of harming their holder. CBT helps people see the link between thoughts and resulting behaviours. A period of ‘reflection’ is encouraged. The person is then better able to critically examine thoughts and replace them with healthier alternatives.
How Cognitive Behavioural Therapy works
During a process known as ‘functional analysis’ addicts are encouraged to analyse thoughts and behaviours. The ‘reasons’ behind thoughts are identified and scrutinised. Patients are taught to recognise specific situations promoting negative thoughts. This helps clients avoid these situations on leaving our rehabilitation centre so relapse does not become a risk.
A process known as ‘skills training’is subsequently attempted. During ‘skills training’ the therapist teaches clients to ‘unlearn’ destructive habits and replace them with powerful coping strategies. Patients are taught how to tackle situations promoting addictive behaviours.
How CBT is implemented
One way of implementing CBT is through written tasks either individually or in groups. Patients are asked to imagine or enact a situation which promotes addictive behaviours. Patients write down every detail imagined. Patients are encouraged to jot down an extensive list of thoughts. Patients identify emotions attached to these thoughts. Finally, clients identify behaviours arising from thoughts and resulting emotions.
In a nutshell, CBT is about helping clients figure out:
- Thoughts arising from situations
- Resulting emotions which direct behaviour
- Challenging thoughts and hence changing emotions and behaviours for the better
CBT is summed up in the below diagram:
Patients backtrack the steps which led to a particular addictive behaviour. Patients begin to understand behaviours are directed through emotional and cognitive processes. If thoughts and beliefs are altered, so too are emotions and behaviours. The therapist helps clients challenge negative and erroneous thoughts so new emotions and behaviours arise.
Typical erroneous beliefs and thoughts (known as ‘cognitive distortions’) include:
- Minimising positives
- Magnifying negatives