Cognitive-Behavioural Treatment of Substance Abuse

Question 1

structure of CBT (length, structure between and within within, flexibility)

Answer 1

• brief length: 12-16 sessions ong.
• structured session plan, broken into 3 or 4 interconnected sessions
• within sessions also a lot of structure: 1) review of the week (homework & issues that arose) and agenda setting, 2) introducing the session theme, 3) planning homework for the next session
• has some flexibility for problems that arise

Question 2

approaches within CBT =

Answer 2

1. relapse prevention
2. cognitive therapy
3. coping skills therapy
4. mindfulness-based cognitive behavioural therapy

Question 3

relapse prevention 3 components

Answer 3

• self-efficacy
• coping
• craving

Question 4

cognitive therapy 2 factors

Answer 4

1. proximal situational factors (immediate triggers of substance use -> cognitive, emotional, behavioural, physiological variables)
2. distal background factors (context of vulnerability factors -> personal history, longstanding cognitive and behavioural variables, personality)

Question 5

coping skills therapy=

Answer 5

1. relapse prevention training
2. social and communication skills training
3. training in coping with urges/cravings
4. mood management

Question 6

mindfulness based cognitive behavioural therapy=

Answer 6

voor SUD: mindfulness-based relapse prevention (MBRP)

Question 7

mindfulness=

Answer 7

purposeful attention to the present and an openness to accept things as they are

Question 8

alternative CBT for SUD

Answer 8

1. brief CBT: primarily focus onm relapse prevention or coping skills therapy. voor moderate-high risk users or patients that are not ready to engage in intensive treatment
2. low intensity CBT: bv non-specialists, self-directed technologies (books, cds, online). can increase access, flexibility, responsiveness, and cost-effectiveness
3. digital CBT: computer-delivered interventions that can help overcome problems of accessibility. ook bv handig dat het anoniem is en voor feelings of shame

Question 9

op welk principe is cbt gebaseerd (general CBT model)

Answer 9

early experiences -> beliefs + trigger -> thoughts <-> behaviours & feelings

Question 10

uitleg van general cbt model

Answer 10

1. early experiences: family, social, environmental
2. beliefs: core beliefs/schematas that can be positive or negative and often feel life facts to the person
3. triggers: external (people, places, events), internal (emotions) factors that trigger our core beliefs and lead to:
4. thoughts which lead to
5. behaviours which are linked to
6. feelings

Question 11

welk onderdeel van cbt heeft het meeste te maken met triggers

Answer 11

relapse prevention

Question 12

3 categories of thought and belief based interventions

Answer 12

1. analyzing approach: identifying thoughts and beliefs and their relationship to feelings and behaviour and considering the helpfulness or unhelpfulness of them (cognitive bias)
2. challenging approach: analysing thoughts and bleifs and utilizing challenging strategies. -> asking for evidence, looking for exceptions and contradictions.
3. accepting approach: noticing and accepting thoughts and beliefs without judgement or necessary further action

Question 13

hoe kan je behaviour aanpakken

Answer 13

interventions can focus on the behaviour itself or the substance

Question 14

hoe kan je feelings behandelen

Answer 14

understanding emotions, identifying their relationships with substance use, emotion regulation, distress tolerance and mindfulness

Question 15

assumptions of CBT

Answer 15

• thoughts, behaviours and emotional reactions are learned and can therefore be unlearned
• therapeutic alliance in necessary but not sufficient
• present focus
• client learns to be their own therapist
• guided discovery: therapist asks questions to promote thinking
• scientist-practitioner: therapist applies the scientific method