Alcohol and other drug problems aren’t destiny – apply the learning model of addiction in treatment
Under a cognitive behavior model both alcohol and other drug use and addiction are considered to be learned behaviors that emerge over time, and can therefore be ‘unlearned’.
They are assumed to operate within a context of a range of environmental influences, including family and friends, availability of alcohol and other drugs and socio-demographic circumstances. Cognitions and emotional responses that come along with the addiction are also considered to be learned.
Therapeutic alliance is necessary but not sufficient for change.
Cognitive behavioral therapies are often accused of ignoring the therapeutic alliance but this is not the case. It is true that, unlike the analytic style therapies, cognitive behavioral therapies do not rely on the therapeutic alliance to create change, but view it as a necessary (but not sufficient) condition for change.
Leahy (2003) describes it like an anaesthetic in surgery. Without it, surgery would be difficult and painful, but if you only had the anaesthetic, the problem would not be rectified.
Cognitive behavioral therapies build alliances in multiple subtle ways to fight addiction.
Collaboration and active participation by consumers in their own treatment is viewed as essential and is an important vehicle to developing a positive therapeutic alliance.
Clients’ negative attitudes to treatment predict poor alliance in Cognitive Behavioral Therapy so a good effective treatment experience can improve therapeutic alliance. Cognitive behavioral therapies are goal-oriented and problem-focused. While treating the whole person is important, addressing the client’s immediate goals through developing problem-solving skills is the initial focus of treatment. In the process of resolving the client’s problems, a therapeutic alliance is naturally developed.
As well as alleviating the clients’ problems, good counseling skills, a flexible adapting style, a collaborative approach, and seeking feedback from the client all contribute to the development of the therapeutic alliance.
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