Is Cognitive Behavioral Therapy Effective for Co-Occurring Disorders?

Cognitive Behavioral Therapy, or CBT, is a form of psychotherapy that teaches a person to question automatic thoughts that may be harmful or inaccurate. By doing this, they learn to understand how such thinking affects their emotions and behavior. Additionally, CBT shows individuals ways to change these self-defeating patterns in their life.

When someone has both a substance use disorder and a form of mental illness, they are considered to have co-occurring disorders, also called a dual diagnosis.

Treating both issues at the same time is considered best for most individuals with a co-occurring disorder. Treatment should be personalized for the individual and their issues. Many people find a combination of behavioral therapy and medication, known as Medication-Assisted Treatment (MAT), to be successful for long-term recovery.

According to the National Institute on Drug Abuse (NIDA), more than 7 million Americans have co-occurring disorders. Only about 9% of those people receive treatment for both conditions.

Types of Co-Occurring Disorders

There are many types of mental illness that can affect someone with an addiction to drugs or alcohol. These include (but are not limited to):

• anxiety disorders
• depression
• attention-deficit hyperactivity disorder (ADHD)
• bipolar disorder
• personality disorders
• schizophrenia

There are several reasons why someone may be dealing with mental illness and addiction at the same time.

For instance, both conditions have common risks factors, including genetic and environmental, that increase a person’s chance of having a mental illness and struggling with addiction. Others may have a mental illness and turn to drugs or alcohol to help manage the symptoms associated with their mental disorder. Finally, the misuse of substances can alter the brain’s structure and function, resulting in the development of mental health problems.

What is Cognitive Behavioral Therapy?

The American Psychological Association (APA) states that “numerous research studies suggest that CBT leads to significant improvement in functioning and quality of life.” The APA shares that this form of therapy is based on several core principles, which include:

1. Negative thinking can lead to negative behaviors.
2. We can learn patterns of negative behavior that can harm us.
3. People suffering from psychological problems can learn better ways of coping with their challenges, helping to relieve their symptoms and become more effective in their lives.

To change our thought patterns, CBT practitioners will work with individuals to recognize when a particular line of thinking is causing a problem and help them reconsider their thought process from a more realistic perspective.

The therapist will also help the person develop better self-esteem, so they are more confident in their thinking, as well as help them to better understand others’ behaviors and motivations. Finally, therapy can help someone with a dual diagnosis learn new problem-solving skills so they can better handle difficult situations when they do arise.

Cognitive Behavioral Therapy also works to address behavior change by teaching the person in recovery how to face their fears and calm themselves in stressful or upsetting moments. Some of this work is done through role-playing exercises that can guide the individual in how to address potentially difficult situations. This allows the person to better prepare for problematic interactions.

What to Expect from CBT

As part of a dual diagnosis treatment plan, CBT may include a combination of the strategies mentioned above. The exact techniques used will depend on the individual and what they and their therapist decide will work best for their situation.

CBT is not considered a long-term therapy. Depending on the person and the situation, the therapist may recommend as few as five sessions or as many as twenty. It’s important for the person in recovery to have an ongoing conversation with their therapist to determine how best to proceed.

• The length of therapy will depend on:
• The type of disorder or situation
• The severity of the individual’s symptoms
• How long the person has had symptoms or has been dealing with the situation
• How quickly they make progress
• How much stress are they experiencing
• How much support they receive from family members and other people

CBT for dual diagnosis can take place in an individual or group setting or both and can be done individually or as part of an addiction treatment program.

Making the Most of CBT

To get the most benefit from CBT, the person seeking treatment should be open and honest with their therapist. Any form of counseling is a partnership between the therapist and the individual. CBT often includes homework that is done between sessions. This work should be taken seriously. Like any form of therapy, results may take time. However, if someone feels like they aren’t benefitting from CBT after multiple sessions, it’s essential to let the therapist know. Their therapist may adjust the modalities they are using or may recommend a different therapeutic approach.

Cognitive Behavioral Therapy can help anyone, but it plays a particularly vital role for people with co-occurring disorders. Treating both substance use and mental health simultaneously is critical to achieving a better quality of life. CBT is most effective when the person receiving treatment is committed to self-analysis and learning how to change their thinking and behaviors.

At Bridges of Hope, our treatment philosophy is based on a comprehensive and integrated approach to addressing all issues related to substance use and mental health disorders. Utilizing therapeutically proven, evidence-based clinical practices, we provide superior client care throughout Indiana.