As the world emerges from one of the darkest moments in its history, people in the United States are slowly returning to living their lives. However, the stain from the pandemic remains, and the drug and alcohol crisis, mixed with mental health, continues to affect people from coast to coast and everywhere in between. The lockdowns, uncertainty, and fear we’ve lived with over the past few years have damaged us in ways that will take more than just time to fix. Fortunately, cognitive behavioral therapy is one such means of overcoming what we’ve encountered, but how bad has the pandemic affected us?
Provisional data released from the U.S. Centers for Disease Control and Prevention (CDC) found that an estimated 107,622 drug overdose deaths occurred in the United States in 2021, an increase of 15 percent from the previous year. As the lockdowns persisted and people started losing their jobs, they sought the comfort of drugs and alcohol to cope. In 2020, 93,655 deaths occurred in the country, while overdose deaths rose 30 percent from 2019 to 2020. The data also found that fatalities involving opioids rose drastically from 70,029 in 2020 to 80,816 in 2021. Fentanyl was the primary driver behind these figures.
The CDC found that the biggest increase in overdose deaths took place in Alaska, with fatalities rising an astonishing 75.3 percent. However, Wyoming did not encounter an increase in deaths, while Hawaii declined 1.8 percent from the same time in 2020. While these states seem to be anomalies, the figures speak for themselves, and the sheer volume of misery we’ve seen across our country can’t be argued. In 2020, there were 57,834 fentanyl deaths, but in 2021, that number was 71,238. Methamphetamine and cocaine deaths also rose dramatically from 2020 to 2021.
There is a direct correlation between mental health and substance abuse, and it shouldn’t come as much of a surprise when 19.86 percent of adults in the United States have a mental illness, equating to nearly 50 million adults. According to Mental Health America (MHA), mental illness ranges from 16.37 percent in New Jersey to 26.86 percent in Utah. Mental illness is defined as a diagnosable, behavioral, mental, or emotional disorder other than a developmental or substance use disorder.
The same study found that 7.74 percent of adults in the United States reported having a substance use disorder (SUD) in the previous year. Of those, 2.97 percent reported having an illicit drug use disorder, and 5.71 percent reported an alcohol use disorder (AUD) in the previous year. The prevalence of substance use disorders ranges from 5.98 percent in Florida to 12.3 percent in Washington, D.C.
These figures paint a grim picture of the current state of affairs in our country. Unfortunately, drug addiction and mental health were already serious issues. However, crippling lockdowns, fear, and the anxiety surrounding the pandemic and our health worsened them. Although we’re slowly moving away and beginning to heal, much damage has been done, which is represented in these figures of deteriorating mental health and widespread drug and alcohol abuse.
As we seek ways to heal our mental health and stop using drugs and alcohol before becoming a statistic, many people have found success with cognitive behavioral therapy (CBT). It’s a highly effective way of battling addiction and bad mental health, but what is it? Can it help you? We’ll delve into the details below.
What Is Cognitive Behavioral Therapy?
The American Psychological Association (APA) defines cognitive behavioral therapy as a form of psychological treatment that has proven itself effective in treating a wide range of issues, including anxiety disorders, depression, drug and alcohol abuse problems, eating disorders, marital issues, and severe mental illness. Numerous amounts of research have been released demonstrating its effectiveness over other forms of psychological therapy or medications. CBT vastly differs from other psychological treatments, and advances in the therapy have been made due to clinical and research practice.
Cognitive behavioral therapy is founded on the following core principles:
- Psychological problems partly stem from improper and unhelpful ways of thinking.
- Psychological issues partly stem from learned patterns of improper behavior.
- Individuals struggling with psychological problems have the capability of learning new ways to cope, thus relieving their symptoms and leading more effective lives.
Through cognitive behavioral therapy, you can focus on changing these automatic adverse thoughts that contribute to and worsen depression or anxiety, which, in turn, may cause the person to use drugs or alcohol to mute how they feel. These negative thoughts directly impact your mood. Through therapy, you will identify, challenge, and replace these thoughts with more realistic ones.
Types of Cognitive Behavioral Therapy
Cognitive behavioral therapy has various techniques and approaches to address your emotions, thoughts, and behaviors, ranging from self-help materials to psychotherapies. There is a broad range of therapeutic approaches that include the following:
- Cognitive therapy: This focuses on identifying and altering inaccurate or distorted thinking patterns, behaviors, and emotional responses.
- Multimodal therapy: This form of CBT suggests that psychological issues require treatment by addressing seven interconnected modalities. These include cognition, behavior, affect, imagery, sensation, drug/biological considerations, and interpersonal factors.
- Dialectical behavior therapy (DBT): This form of CBT, known as dialectical behavior therapy (DBT), addresses behaviors and thoughts while implementing strategies like mindfulness and emotional regulation.
- Rational emotive behavior therapy (REBT): Rational emotive behavior therapy (REBT) is another form of CBT that identifies irrational beliefs and challenges them. It enables you to learn and recognize these thought patterns, leading to long-term change.
Although each form of cognitive behavioral technique takes a different type of approach, they all work to address negative thought patterns that cause psychological distress. Depending on what you’re looking to overcome, such as mental health problems or drug addiction, the therapist will implement a different approach. Below, we’ll discuss the various techniques of CBT.
Types of CBT Techniques
Cognitive behavioral therapy is more than identifying specific thought patterns. It’s focused on using a broad range of techniques to help you overcome these thoughts, which could be leading to depression or anxiety, and then numbed by alcohol or drugs. The most common types of CBT techniques include mental distractions, journaling, role-playing, or relaxation techniques.
Practicing New Skills
It’s vital to practice new skills, which will then be put to use in real-world situations and allow you to function normally in that scenario. Someone battling a substance use disorder can start practicing new coping skills and rehearsing methods to avoid or cope with social situations that can lead to a relapse. In some cases, triggers may be something you need to deal with head-on, so finding new ways to deal with them in the moment will help immensely.
Identifying Adverse Thoughts
To overcome addiction, depression, anxiety, or any other issue you’re faced with, learning how your thoughts, feelings, and specific situations can contribute to poor behavior is important. While this process will be fraught with challenges, especially for someone who struggles with introspection, it can lead to self-discovery and other insights that are crucial to the healing process.
Setting goals is among the most important steps to recovering from addiction or mental illness. It allows you to positively change your life and health. You and your therapist will set goals during your time in cognitive behavioral therapy. The therapist will help you develop your goals, identify them, distinguish the difference between long and short-term goals, set SMART (specific, measurable, attainable, relevant, time-based) goals, and teach you how to focus on the process and the outcome.
One of the most crucial pieces of CBT is the ability to learn how to solve problems. Problem-solving skills help you identify and solve issues that are caused by external stimuli, both large and small, and help you reduce the adverse impact of physical and psychological illness. There are five steps when it comes to solving problems with CBT. They are:
- Identify the issue.
- Develop a list of potential solutions.
- Evaluate the strengths and weaknesses of each potential solution.
- Find the solution you’re going to use.
- Implement that solution.
Self-monitoring is sometimes referred to as diary work, and it’s another vital component in CBT that involves tracking symptoms or behaviors you experience and sharing them with your therapist. Self-monitoring helps you give your therapist the necessary information, enabling them to provide you with the best treatment. If you’re battling an eating disorder, self-monitoring means you’ll keep track of your eating habits. You might also keep track of how you felt when you ate that meal or snack. Was it negative? Was it positive? This can help your therapist craft a plan of action.
What Does Cognitive Behavioral Therapy Help?
As mentioned earlier, cognitive behavioral therapy is often used in place of medication and other therapies due to its effectiveness. It can be used as a short-term treatment that helps you focus on present thoughts and beliefs, but it can also be used long-term for as long as your therapist deems necessary.
Cognitive behavioral therapy addresses various conditions, including the following:
- Anger problems
- Bipolar disorder
- Panic attacks
- Eating disorders
- Personality disorders
Cognitive behavioral therapy has also been shown to help those with the following:
- Grief or loss
- Chronic pain or other serious illnesses
- Breakups or divorces
- Relationship issues
- Low self-esteem
- Stress management
Cognitive Behavioral Therapy for Substance Use and Addiction
As mentioned above, cognitive behavioral therapy is a form of talk therapy based on the psychological principles of behaviorism. These deal with how behavior is controlled and focuses on understanding how people feel, think, and view themselves. The treatment focuses on changing thoughts and behavioral patterns, but how does it address substance abuse? Below, we’ll discuss the impact CBT has on those battling addiction and its effectiveness as a treatment for this condition.
Addiction involves misusing substances or doing things compulsively, no matter the adverse consequences that might follow. When someone tries to overcome their dependence on drugs or alcohol, they’ll say something like they want to change. In most cases, this will be true, but they don’t even know where to start. Between the withdrawal process, post-acute withdrawal syndrome (PAWS), and other factors, it’s extremely challenging to get sober. Even if you’re tired of the lifestyle where you wake up, commit regrettable actions to obtain money, use to avoid sickness, and repeat, it’s not easy to stop.
The CBT approach states that addictive behaviors are the result of inaccurate thoughts, leading to adverse feelings. Most of us have dealt with opinions or beliefs that are unrealistic, untrue, or impossible to let go of. These thoughts cause us to think negatively and feed depression, anxiety, and addictive behaviors, including the following:
- Gambling problems
- Misusing or abusing drugs
- Misusing or abusing alcohol
- Compulsive shopping
- Food addiction
- Video game addiction
- Other forms of excessive harmful behavior
When cognitive behavioral therapy is used to treat addiction, it focuses on recording the thoughts, feelings, and events that trigger those negative thoughts and feelings. When we reach a point of understanding where the addictive behaviors stem from, we can start changing the automatic processes that disrupt our efforts to change these behaviors.
Cognitive behavioral therapy allows us to examine patterns of feelings and thoughts we repeatedly experience. As time goes on, we can start to change these thoughts by implementing a more realistic point of view. Once this is done, we won’t resort to negative emotions that lead to harmful behavior patterns.
When we continually reward ourselves for positive and healthy behavior, these healthier behaviors will be attached to positive emotions, which then become automatic.
Substance use and misuse involve taking a substance in a way that’s not intended or taking more than prescribed medication. For example, if you become tolerant of your pain medication and start taking more against your doctor’s orders, this is a form of substance abuse. Taking a drug that’s not prescribed to you is also a form of substance abuse. It’s typically treated with cognitive behavioral therapy. However, some people may benefit from medication-assisted treatment (MAT) to overcome an opioid use disorder (OUD).
CBT can help individuals change their habits with substances because it’s focused on helping you learn how to identify and challenge negative behaviors. Cognitive behavioral therapy also teaches you how to cope with stress, cravings, and relapses.
Cognitive Behavioral Therapy for Mental Health
Cognitive behavioral therapy is an excellent option if you’re suffering from mental health conditions like depression or anxiety. There are various approaches to psychotherapy for those battling poor mental health or addiction. However, CBT is the most effective in treating depression, anxiety, borderline personality disorder (BPD), and other conditions. CBT was developed by Aaron Beck specifically for anxiety and depression. It’s a blend of cognitive and behavioral therapies that help individuals tune into their internal dialogue to change their thinking patterns.
There isn’t one type of CBT that’s effective for each mental health condition. For example, dialectical behavior therapy was developed and used to treat individuals who have borderline personality disorder. DBT emphasizes working on accepting feelings and thoughts instead of fighting them. The primary objective is to get the individual to acknowledge their feelings and thoughts with the goal of changing them.
Exposure and response prevention therapy (ERP) is another form of cognitive behavioral therapy that’s primarily used in the treatment of obsessive-compulsive disorder (OCD). This type of CBT exposes patients to situations or objects that cause them the most fear but cannot engage in behaviors that help them relieve their anxiety. If you’re afraid of germs, your therapist will have you touch money and not let you wash your hands for a specific timeframe. Once you practice this over and over, you’ll gain confidence in dealing with the anxiety, subsequently alleviating your OCD symptoms from repeated exposure.
Researchers have had issues researching the effectiveness of psychotherapy for depression because it can refer to many activities. However, CBT is scientifically proven to treat depression, anxiety, and other forms of mental health issues. The treatment tends to be on the shorter side in comparison to other therapies. However, the individual can go through it for as long as they need. The primary objective is to educate the individual about becoming their own therapist.
How Effective Is Cognitive Behavioral Therapy?
Today, cognitive behavioral therapy is one of the most recognized and validated forms of treatment for a broad range of conditions. CBT is the leading evidence-based treatment for individuals battling eating disorders, and it has been proven highly effective in helping people with insomnia get better rest without medication. CBT has also been scientifically proven to be effective in treating the symptoms of anxiety and depression in young children and adolescents.
A meta-analysis of 41 studies from 2018 proved that CBT assisted in improving the symptoms of those with anxiety-related disorders, including post-traumatic stress disorder (PTSD) and obsessive-compulsive disorder (OCD). CBT also has a live level of support in the treatment of substances. It’s been proven to improve self-control, develop coping mechanisms, and avoid triggers. CBT is one of the most well-researched forms of therapy due to its highly specific goals and the ease with which its results are measured.
What Are the Challenges of Cognitive Behavioral Therapy?
Yes, cognitive behavioral therapy is an excellent means of treating mental health conditions and substance use disorders. However, it’s not magic, and you can run into some challenges during your treatment. Below, we’ll discuss the most common issues associated with CBT.
No One Likes Change
We get it – change is difficult, and some people who start CBT mention that while they know their thoughts are not healthy, becoming aware of them isn’t enough to overcome them. It takes time, willingness to change, and patience.
CBT is highly structured, so sometimes it’s better suited for those who are comfortable in a structured and focused environment where the therapist takes an instructional role.
Progress Occurs Gradually
We all wish we could snap our fingers and cure depression, anxiety, addiction, or any other problem we face. However, that’s not the case. While CBT is highly effective, it’s a gradual process that helps you take incremental steps toward behavioral change. You can’t be discouraged if you don’t get immediate results. However, as long as you practice patience, the gradual progress will pay off. When you progressively work toward a big goal, the process is less daunting. Short-term goals are easier to achieve. If you’re ready to get help, contact your doctor and find out how the process works.