Clinical Textbook of Addictive Disorders 3rd ed - R. Frances, S. Miller, A. Mack (Guilford, 2005) WW

22. Cognitive Therapy 497lengthy course of treatment (e.g., two full rounds of the DBT skills modules,and sessions three times per week). In cognitive therapy, such imperatives arenot required. Second, and again, likely due to the nature of BPD, therapists usea team or community-of-therapists approach, and therapists are asked to beavailable after hours for phone coaching of clients. Cognitive therapy followsmore traditional therapist roles. Finally, whereas both DBT and cognitive therapyfocus on teaching new coping skills, the skills themselves differ to somedegree. For example, cognitive therapy focuses much more formally on changingcognitions through the use of structured tools for cognitive change such asthe Dysfunctional Thoughts Record.CONCLUSIONCognitive therapy can be an effective treatment for substance abuse patients. Itrequires accurate conceptualization of the patient, a sound treatment planbased on this case formulation, a strong therapeutic relationship, and specializedinterventions. Structuring the therapy session, problem solving of currentdifficulties, education about the sequence of substance use, planning for highrisksituations, monitoring of substance use, lifestyle change, and intensive casemanagement are important facets of treatment.Kim could easily have become an unemployed “revolving door” user and aburden to family, friends, and society. Cognitive therapy helped her to engagein therapy, work through dysfunctional beliefs about herself and the therapist,develop functional goals, learn new skills to solve problems, tolerate negativeemotion, persist when she felt hopeless, engage in alternative behaviors whenshe craved substances, and develop a healthier lifestyle. Hard work by both thetherapist and substance abuse patient can pay off handsomely.APPENDIX 22.1. SUBSTANCE ABUSE RECOVERY RESOURCES*Resource Website PhoneNational Drug Information, Treatment www.drughelp.org800-662-HELPand Referral LineNational Clearinghouse for Alcohol www.health.org 800-729-6686and Drug InformationAlcohol and Drug Healthline www.samsha.gov 800-821-4357Alcoholics Anonymouswww.alcoholicsanonymous.org800-637-6237Cocaine Anonymous www.ca.org 310-559-5833Narcotics Anonymous www.na.org 818-773-9999