Substance Abuse Archives - Cognitive Therapy of Boca Raton

Cognitive Behavior Therapy for the Treatment of Alcohol Abuse

There is no question about it. Many people drink too much alcohol and have done so for many years. While some people can “moderate” their drinking, a great many have to accept the fact that they cannot and need to stop all together and forever.

Alcohol treatment Cognitive Behavior Therapy (CBT) provides individuals a method to understand what their triggers are for drinking, what is maintaining it and develop healthy and effective skills to eliminate from their life. Often times there are a number reasons that maintain a person’s drinking habit.

In one recent case, a client reported that she would drink at the end of the day to “relax”, but 1 drink would lead to 6 or more! She would drink in the presence of her boyfriend as a social activity. She would drink when she was bored. When at a party, she would drink to “celebrate”. When at a club, she would drink to reduce her “social anxiety”. The alcohol was threatening her potential marriage, putting her at risk for driving accidents, and had resulted in significant weight gain which impacted her self image and more!

In Cognitive Behavior Therapy, we use many strategies to help the client understand and to motivate them towards change. These methods may include motivational interviewing to enhance the desire for positive change, training in relaxation methods to reduce the physical sensations of anxiety and developing rewards to increase. Positive behaviors and punishments to decrease negative behaviors. Through the use of customized “homework assignments” clients learn how to more effectively manage urges to drink, and live more effectively when exposed to situations where alcohol is present.

Once an individual has stopped drinking, we go through a series of future oriented practice exercises, known as “relapse prevention” to strengthen their confidence and resiliency. Depending on the situation we might recommend they participate in a group like SMART Recovery or AA, involve the family for support, and in some cases, recommend an evaluation to consider whether or not the use of specific medications my be useful.

Cognitive Behavior Therapy practitioners have many tools in the toolbox to help clients free themselves from alcohol and other substance abuse problems.

For additional information or those seeking virtual counseling anywhere in Florida or Massachusetts, visit www.cognitivetherapyfl.com or contact Dr. Robert Heller at drrobertheller@gmail.com or call/text 561 251-9768.

Psychologist Finds Effective Treatment for Alcohol and PTSD

A study published in the Journal of the American Medical Association by well- known psychologist and researcher Dr. Edna Foa, found that those treated with prolonged exposure therapy and medication did the best in lowering percentage of drinking days and cravings when compared to a variety of different treatment groups six months after treatment.

Exposure therapy is a well-established method used by cognitive behavioral psychologists while naltrexone is a popular medication used in alcohol treatment. In the past, when the alcohol problem was treated without treating PTSD (post traumatic stress disorder), the PTSD would become more severe and the individuals would start drinking again according to Dr. Foa.

This finding is similar to my own experience in working with clients that have alcohol and/ or drug problems and co-conditions of PTSD.

They use the alcohol to self medicate themselves from the painful memories and feelings associated with their trauma. Therefore it is important to target both areas for treatment to reduce the risk of relapse.

For the treatment of PTSD, I have increasingly found that EMDR (eye movement desensitization and reprocessing ) to be a helpful process which works well in combination with cognitive behavior therapy methods to treat the alcohol and / or drug problems. Based on this new study, it may be worthwhile to recommend naltrexone for more resistant cases.

Increasingly, treatment centers are integrating more comprehensive methods in rehabilitating alcohol and drug issues by including sessions using EMDR, cognitive behavior therapy, acupuncture, biofeedback and yoga therapy.

In my own psychology practice located in Boca Raton, Florida I provide one of the few alternatives to traditional AA meetings and 12 step approaches. Clients can continue to attend 12 step programs if they wish or they are invited to join a SMART Recovery Group on line to support their work with me in individual therapy using cognitive behavioral therapy, EMDR, hypnosis and yoga based practices.

Relapse Prevention for Substance Abuse

Relapse prevention for substance abuse is among the most challenging issues facing those in recovery. Clients often benefit by focusing both on the underlying causes that lead to the substance abuse as well as the current and possible future triggers that may re-activate it.

The cognitive behavioral approach for relapse prevention for substance abuse often starts with the client efforts to become aware of their thought. THOUGHTS, trigger additional thoughts or repeated thoughts that give rise to FEELINGS or desires/urges that then lead to negative BEHAVIORS and then lapses or relapses.

Your first step in to RECOGNIZE what you are thinking at the earliest stage of this chain of events.

Early recognition of thoughts associated with using alcohol or drugs gives you more time stop and think differently before you act.

Awareness leads to CONTROL and the chance to make different choices.

A useful mantra to live by is, “Never let a negative thought go unchallenged”.

Your second step is to examine and challenge/dispute what you are telling yourself. Think about the consequences of your actions. Consider other ways of dealing with the underlying issue that gives rise to the urge to use. Develop and use alternative coping responses such as deep breathing, muscle relaxation and guided imagery.

Replace your negative thoughts with positive, helpful and rational ones. Do this BEFORE you actually find yourself in difficult situations.

Consider how you would like to think, feel and respond when negative thoughts and/ or urges arise. Review this desired response in detail.

Then FREQUENTLY and STRONGLY tell yourself these healthier ideas. Write them down, record them on your phone and repeatedly listen to them. Say them out loud.

Your goal is for the newer, healthier thoughts to become a strong and automatic reaction to old triggers associated with using.

Next, create a clear image or picture of yourself, having a thought or urge and then successfully overcoming it through the steps you have been practicing.

Practice the cognitive behavioral approach to relapse prevention for substance abuse and you can remain free of your addictions for a very long time.