Cognitive Behavioral Therapy (CBT) is considered, by the American Psychological Association, to be an evidence-based form of therapy. That means this particular form of therapy has been studied by experts multiple times, and in each study, the experts have found that the therapy was capable of delivering real results that could be both measured and duplicated. In other words, this is a therapy that is proven to work.
CBT works, in part, by helping people to understand the process of addiction. In early sessions, people work with a therapist in order to understand what drug cravings feel like and where they come from. Next, people work with a therapist on methods they can use to avoid a trigger that leads to a relapse to drugs. But CBT has another aspect that is equally important. In fact, the National Institute on Drug Abuse says that a therapist’s ability to teach coping skills is at the core of CBT. These are the skills people can lean on when they cannot avoid a relapse trigger. Using these skills could help them to stay sober.
List of Cognitive Therapy Skills
- Relaxed breathing
- Progressive muscle relaxation
These are five of the CBT therapies a clinician might teach a client during skill-building sessions:
- Relaxed breathing: A person under pressure or stress tends to take very short, quick breaths. Those short breaths can feel a lot like panting, and that can make deep portions of the brain awaken with fear. Breathing like this can make the brain feel as though the body is under attack, and that can make a sense of panic start to rise. Relaxed breathing techniques involve slowing down the breathing process, so the person begins to take deep breaths at a slower, regulated pace. Therapists can teach people this technique by marrying breathing to counting. People might breathe in while counting to five, and then breathe out while counting to five. That counting and breathing can allow a sense of panic to fade.
- Progressive muscle relaxation: Just as breathing moves quickly when people are under pressure, muscles can tense and knot when people feel fear and concern. The progressive muscle relaxation technique, according to Mayo Clinic, is designed to help people recognize what knotted muscles feel like, so they can correct and smooth those muscles when they are tense for no real reason. Therapists teach their clients to tense the muscles in the toes, hold that pose for a moment, and then release the tension. Next, the person would tense muscles in the arches of the feet. The calves would come next. The person would tense and relax muscles all the way up to the head. Tense muscles can release with this method, and people may become aware of when their muscles grow tense next time.
- Visualization: People feeling a drug-related craving are often flooded with memories of what it was like to prepare or ingest drugs. Those memories can deliver intense sensory experiences, and those senses can make drug use seem inevitable. The visualization technique is designed to block those disturbing memories, so people can focus their minds on something else. People who use this technique close their eyes, sit quietly, and think about a specific place in which they felt calm and serene. They should try to think about how the place looks, smells, tastes, and sounds. They should try to envision what it is like to be in that place instead of the place they have been. It can take practice to get those memories clear and present in a person’s mind, but when those memories are in place, they can work like a safe space the person can retreat to at any time stress looms.
- Biofeedback: This method of therapy is designed to help people check in with more than just breathing and muscle tightness. This form of therapy is made to help people understand how their entire bodies are reacting to an outside stimulus. There are machines involved, and therapists place people inside of those machines and ask them to relax breathing, unclench muscles, and slow heart rates until the machines reach a point at which the person’s readings indicate relaxation. This method is a bit like a video game. It can have great results for people, even when they are not hooked to the biofeedback machine. For example, in a study in the journal Biofeedback, researchers report on a golfer who had 10 sessions of biofeedback training. In each session, his numbers improved. During that time, his golf scores improved by 15 shots. Clearly, this man was not attached to a biofeedback machine while playing golf, but his golf scores really improved due to his biofeedback work.
- Meditation: This method of treatment is designed to help people use the power of the mind to move through a stressful period. It is one of the most studied forms of alternative therapies, and in a review of 47 trials, researchers suggest that meditation can ease symptoms of anxiety, depression, and pain, says Harvard Medical School. People who follow this technique are instructed to clear their minds of outside inputs. That means they stop paying attention to the radio, the television, people talking, and kids shouting. They also stop listening to the little inner voice inside their brains. They do not think about drugs, jobs, or responsibilities. Instead, during a meditation session, people simply focus on breathing in and out and letting go. A few minutes of meditation like this in the middle of a crisis can be useful, but people might also use this technique as a sort of daily touch-up, so they will be more resilient in general.
- Yoga: Many of these techniques involve sitting quite still, and for some people, that can be an issue. These are people who like to move through a stressful sequence with the help of their muscles and ligaments. For people like this, yoga might be a better option. This is an ancient form of exercise in which people move through a series of poses in a slow and graceful manner. This can tone the muscles and enhance a sense of balance. Yoga also involves components of meditation. People doing yoga are encouraged to breathe in a specific way and hold breaths from time to time. People who practice yoga regularly may find that it is easier for them to quiet their minds when that is required. They can find their focus, where it may have escaped them in the past. Therapists might teach yoga directly in CBT sessions, or they might assign yoga as CBT homework for the people in their care.
All of these skill-building techniques are important players in terms of CBT success. And CBT really can be successful. In a study of nine clinical trials, published in Alcohol Research and Health, researchers found that better coping skills were associated with enhanced ability to avoid drinking triggers. The more people know about coping, the better they can actually cope when a crisis hits. These therapies might mean the difference between staying sober and sliding back.
It is important to remember, however, that these therapies work best when they are used consistently. That means people must practice often, and they must work at getting better in each and every practice. Those who do will find that they will improve their ability to avoid a relapse. Practice might be time-consuming, but when sobriety is on the line, the work is definitely worthwhile.