Transcript Cognitive Behavioral Therapy for Substance Use Disorders

Cognitive Behavioral Therapy
for the Treatment of
Substance Use Disorders
Sheila Specker, MD
American Board of Addiction Medicine Foundation
Summary of Module Contents
• Slide deck : N = 38
• Notes for lecturer: not available
• Handout materials: practice exercises and
instructions
• Annotated bibliography: available
• Test questions: 4 pretest, 4 post-test
• Other: patient brochure with resources,
webinar link
Cognitive Behavioral Therapy for Substance
Use Disorders
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CBT is skill based and effective
Challenging thoughts about use changes behavior
Key point: CBT principles are very applicable to SUD’s
3 main recommendations:
– Use CBT practice skills, functional analysis, relapse
prevention
– Individualize CBT
– Add pharmacotherapies to CBT
CBT Principles Apply to SUD
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Short-term application (weeks)
Studied in rigorous clinical trials
Structured, specific, goal oriented
Focuses on immediate problems
Individualized (including internet based)
Example of Topic:
Self-Monitoring Record
(Functional Behavioral Analysis)
Trigger
(Person, Place, Thing,
Idea, Institution)
“_____ sets me up and
then I want to use”
Thoughts and Feelings
Behavior
Positive Consequences
“I was feeling _____”
“After the trigger
And feelings, I (did)
________”
This positive thing
happened
“I was thinking _____”
Negative
Consequences
This negative thing
happened
Recommendation #1
Use CBT principles of practice skills, functional
analysis, relapse prevention in treating alcohol
use disorders in practice
SORT level = A
References:
– Ball, SA, et al. Addictive Behavior, 2007, 32(6), 1105-1118
– Dutra, L, et al. American Journal of Psychiatry, 2008, 165(2),
179-187
– Whitlock, E, et al. Annals of Internal Medicine, 2004, 140 (7)
,557-566
Recommendation #2
Individualize CBT for topic, session #,
in-person/internet (SORT A)
Example of topic choices
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Functional analysis,
Coping with cravings,
Managing thoughts about drinking,
Problem solving,
Drinking/drug refusal skills,
Coping with high risk situations,
Seemingly irrelevant decisions
Reference
– Litt et al. Addiction, 2009, 104, 1837-1848
Dissemination Strategy
• Didactics
– Seminar series for psychiatry residents and
addiction fellows (done, ongoing)
– Grand Rounds, University of MN Psychiatry (done)
– CME presentation: statewide Minnesota
Psychiatric Society (Nov. 2014 planned)
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Patient brochure (designed)
ABAM MOC (planning)
Webinar (planning)
Manuscript for publication (discussing)