Substance addiction is a complex issue that is heavily based on a person’s mental health and thought patterns. It is not a moral failing; rather, it has its basis in the brain as a behavioral process.
As such, it is common for substance abuse to be further worsened by co-occurring mental health disorders, creating a cycle that may be hard to break. However, therapists can use CBT (or cognitive behavioral therapy) to help patients address both their existing mental health disorders and their substance dependence at the same time.
Cognitive behavioral therapy is not just talk therapy to help patients “feel” better about themselves. Instead, it is a practical strategy that teaches participants how to gradually alter their thoughts — and thus, their behaviors — to align with the life they want to live.
Approaching addiction when other mental health challenges are present requires a multifaceted approach, but it is possible.
The Mental Health and Addiction Feedback Loop
Many people can fall prey to addictive behaviors or substance abuse without any other mental health disorders, but it is common for these two issues to coincide.
For instance, if a person faces severe anxiety, they may not have the coping mechanisms necessary to live their life with sufficient calmness or rationality to achieve their goals.
As a result, patients may turn to alcohol or other substances that can suppress their anxious feelings, allowing them to get things done or overcome the challenges they face.
The anxiety creates a feedback loop reinforcing the substance abuse. Thus, to address a patient’s substance use disorder, it is essential to treat their anxiety as well.
How CBT Helps During Rehabilitation
Cognitive behavioral therapy focuses on the relationship between thoughts, feelings, and actions. In other words, a person’s thoughts impact how they feel, and those feelings often prompt them to act in a certain way.
By slowly reforging these connections, CBT participants can address their co-occurring mental health disorders and their substance abuse to strengthen behaviors that serve them, not set them back.
Cognitive Restructuring
Cognitive restructuring is the process of finding and then challenging harmful beliefs that contribute to a person’s undesired actions. For example, if a person believes that they cannot function at work without their substance of choice, CBT would have that person challenge this idea.
If their alleged inability to function comes from anxiety or another mental health disorder, addressing the anxiety first (through the same method) can be effective.
Once the problematic thought is identified, challenging it requires creative thinking. What evidence is there that the allegation is true? What evidence indicates that this idea is false?
Can the patient attempt their work responsibilities without the use of substances in small but incrementally increasing difficulty to demonstrate that they do, in fact, possess the knowledge and fortitude to succeed?
Skill Development
Another essential aspect of CBT is developing practical skills to prevent a return to the substance. The good news is that this strategy works for co-occurring mental health disorders, too!
Skills can include ways to mentally redirect away from a temptation, how to manage stress to avoid returning to a coping mechanism, and how to de-escalate anxiety and panic attacks.
CBT also teaches and encourages effective communication skills so patients can articulate when they need support. They learn problem-solving strategies unique to them that grant them a broader view of how to tackle the challenges they face — whether arising from their mental health condition, their addiction to a substance, or both.
Behavioral Alteration
Many cognitive behavioral therapy sessions will approach the treatment of substance use and mental health disorders simultaneously because they are often deeply intertwined. One of the most effective means of doing so is behavioral alteration, or practicing methods of changing undesirable actions.
For example, let’s return to the person suffering from severe anxiety. If they struggle to speak to customers at work due to fear, CBT may allow them to practice engaging with customers (without resorting back to their substance to cope) using role-play.
It can also create reward systems to reinforce when things go well, and some types of substance abuse triggers can gradually change through this exposure therapy.
Try CBT for Dual Diagnosis Substance Abuse Rehab
Facing a substance abuse disorder with a co-occurring mental health diagnosis can make the treatment process more complex, but it does not mean that recovery is impossible.
In fact, those who make progress in one facet of their struggles often see significant recovery in other areas as well, thanks to the skills learned in CBT.
The experts at Aquila Recovery Clinic in Washington DC can help patients with and without co-occurring mental health disorders to achieve long-term recovery. Contact Aquila to schedule your own CBT appointment.