Substance dependence is an addiction to anything that may initially, temporarily, have made you feel better. Substance dependence commonly refers to illegal, recreational drugs such as cocaine or heroin, but it's also possible to become addicted to prescription medication, nicotine, solvents and other inhalants. The National Institute for Health and Care Excellence (NICE) recommends that Cognitive Behavioural Therapy (CBT) is one of the most effective treatments for this form of addiction. We asked RSCPP therapists to explain what CBT is and how it can be used to treat substance dependence.
CBT is a treatment modality that focuses on helping you identify and change unhelpful beliefs, thoughts and behaviours which maintain psychological difficulties and problematic behaviours.
In the case of substance abuse, CBT can help in a variety of ways. First of all, it can help build your motivation to change, by identifying the advantages and disadvantages of using and what would be desirable about giving up. It can also help you identify thoughts and beliefs that maintain dependence, such as 'all or nothing' thoughts ('I have smoked one cigarette, I might as well have the whole packet and start again tomorrow'), negative predictions ('I will never manage to give up') or permission giving thoughts ('I have had such a difficult day, I deserve a drink'). With the third wave of CBT treatments, you can expect to be taught techniques such as mindfulness meditation, which helps you tolerate cravings and treat thoughts as passing phenomena.
The number of sessions required depends on your circumstances and the severity of the problem.
CBT is suitable for clients who recognise they have a problem and are willing to work with the process. CBT requires a great deal of hard work, commitment and, most importantly, acceptance for change.
At its heart, any form of addiction is centred on two fundamental errors: habitual behaviour (i.e. using the addictive substance) and habitual thinking (the idea that behaving differently is impossible.) Given that the whole purpose of CBT is to correct harmful ways of behaving and thinking, it is an effective way of helping addictive clients. CBT lies at the core of the world's biggest addiction recovery organisation (Alcoholics/Narcotics Anonymous) and it is also the basis upon which nearly every other rehab agency works too. CBT is certainly a good way to begin anyone's journey from addiction back to mental and physical health but, for some recoverers, as their minds start to clear, different, more insight-based psychotherapies might also become useful.
What is most important is that you should feel comfortable with your therapist and have confidence in their ability to help you. Always check that your therapist is affiliated to reputable professional organisations and that he or she has insurance.
All therapists on rscpp.co.uk are accredited, registered or chartered by a UK professional body. Therapists who offer Cognitive Behavioural Therapy will in addition have completed training in cognitive behavioural practice.