Cognitive Behavioral Therapy

Cognitive-behavioral therapy (CBT) is based on the assumption that the learning processes used by patients to initiate and continue their drug use behaviors can also be used to reduce or stop their drug use. CBT has been extensively studied, especially with cocaine users, and has shown good results. CBT is primarily used in the outpatient setting, usually with weekly individual sessions over several months. Sessions focus on patients learning to recognize the situations in which they are most likely to use drugs, learning to avoid those situations, and learning to cope with their problems without resorting to drug use. These lessons are accomplished through functional analysis and skills training. In functional analysis, each episode of drug use is analyzed in terms of what the patient was feeling, thinking, or doing before and after the use. This helps identify high-risk situations or coping issues. Skills training involves working on ways to avoid these situations and learn new (or reconnect with past) coping mechanisms for handling high-risk situations and other life stressors without using drugs (Carroll, 1998).

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