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Reinforcement-Based Treatment for Substance Use Disorders - Essay Example

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Middlebury College
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Substance use addiction is a disorder that needs immediate treatment to help individuals affected to resume their normal life (Thomlison & Thomlison, 2017). Addiction to substance use is classified as a chronic disease that is marked by uncontrolled drug seeking and use despite harmful effects, which can be long-lasting. It leads to changes in the brain that can result in abnormal behaviors. It is considered a relapsing disease that requires proven interventions to completely help addicted individuals free from the disorder (Thomlison & Thomlison, 2017). Two of the most empirically researched substance use disorder treatments include the cognitive behavioral therapy and detoxification or medical treatment.

Overview of Treatment Approaches to Addictions Counseling

Cognitive Behavioral Therapy (CBT) encompasses self-instructional training given on an individual basis or in a group, to assist the people with substance use disorder to cultivate a more organized and reflective approach to thinking as well as behaving, including social relations (Center for Substance Abuse Treatment (U.S.), 2012). This therapy is beneficial to the patients addicted to substance use because it helps them to reverse negative thinking patterns. This is helpful as it limits frustration and stress by enabling the affected individuals to embrace a more systematic, reflective and goal-oriented approach to solve problems and daily activities (Kelley, Bravo, Braitman, Lawless, & Lawrence, 2016). This helps to align their brain to restrain themselves from engaging in the use of drugs and instead develop an altogether new behavior that helps them overcome substance use disorder.

The other approach is the use of medication or detoxification. Use of medication is a treatment approach that is used to prevent relapse, withdrawal symptoms and treat co-occurring conditions. This approach is considered an empirically proven intervention recommended for managing chronic substance disorders along with the use of counseling and behavioral therapies (Tuten & American Psychological Association, 2012). It is undertaken over a given period in what is referred to as a long-term medication-assisted treatment.

Treatment Differences

The two treatments approaches differ in various respects. Whereas cognitive behavioral therapies targets to alter the harmful behaviors of those affected, medication therapy, on the other hand, is a pharmacological treatment that helps the affected individuals receive relevant detoxification to avoid potential relapse.

The use of medication is often adopted as the first step during the treatment process to set the stage for further treatment (Thomlison & Thomlison, 2017). It is mainly administered to suppress the withdrawal symptoms as further treatment is provided to the patients to help them overcome the use drug. The medication assists the patients re-establish normal brain functions and lower their cravings for substance use. It uses different medications to treat addictions to various drugs such as opioid, tobacco, and alcohol addiction (Thomlison & Thomlison, 2017). This implies therefore that for every patient who uses more than one drug he or she would require medical treatment for all the substances they use.

On the other hand, cognitive behavioral therapy involves sessions of counseling that help patients manage their addictions by changing the way they think and behave. This form of therapy is based on the principle that thoughts, feelings, physical sensations, and actions are interlinked and patients with negative thoughts and feelings are often trapped in a vicious cycle, which predisposed them to drug addiction (Kelley, Bravo, Braitman, Lawless, & Lawrence, 2016).

Preferred Method and Rationale

The preferred method for treatment is the use of cognitive behavioral therapy. This is because unlike the use medication that treats only the withdrawal symptoms cognitive treatment helps the patient, in the long run, recover from the mental side effects (Center for Substance Abuse Treatment (U.S.), 2012). It helps in addressing the underlying causes of substance use addiction that medication alone cannot achieve. The CBT is an empirically proven intervention that goes deeper to help resolve the factors that may have led to drug abuse in the first place. For more than three decades, use of evidence-based behavioral therapy has been proven as an effective approach in the treatment of alcohol and drug addiction, particularly in individuals with complications such anxiety, depression and obsessive-compulsive disorder (Center for Substance Abuse Treatment (U.S.), 2012).

During treatment sessions, which can last for thirty to ninety days, patients are given individualized training that addresses the underlying factors that may have led to drug use (Tuten & American Psychological Association, 2012). The therapists will break down the major factors that facilitated the problem into separate parts, for example, thoughts, physical feelings, and actions of the patients. The therapist will then meet with the patients on scheduled sessions for about thirty to sixty minutes per session. Depending on the complexity of the addiction, the course of treatment would range from five to twenty sessions.

The therapist will analyze and cover in depth the core causative factors, guiding and counseling the patient to see whether these factors are helpful or realistic and access the effect they have on the patient (Tuten & American Psychological Association, 2012). The therapist would then utilize their professional training to help the patient work out an appropriate plan on how to change unhelpful behaviors and thoughts.

Unlike the use of medication that in some instances cannot work CBT teaches the participants important practical and useful strategies that patients can apply in their daily life to overcome cravings for substance use (Kelley, Bravo, Braitman, Lawless, & Lawrence, 2016). It is highly structured and can be administered in different formats, for instance in groups or individual counseling sessions. The sessions may be administered in inpatient medical facility or well-secluded residential center.

The counseling programs prepare the patients for life after the intensive treatment by equipping them with new skills to cope with the causes of their addictions and thus handle the life's stressors successfully.

Treatment Professionals

Treatment professionals specialized in the treatment of substance use disorders includes the psychologists, social workers, physicians and nurses (Tuten & American Psychological Association, 2012). They are required to work as a team to facilitate effective treatment process. Physicians are required to carry out a diagnosis of the patient and prescribed appropriate medication for their treatment. Nurses are required to monitor the patients treatment process and report any relapse to the physician. On the other hand, psychologists and social workers are required to offer counseling and rehabilitation services to help patients develop positive behaviors to prevent any case of relapse.


Thomlison, R. J., & Thomlison, B. (2017). Cognitive behavior theory and social work treatment.

Social work treatment: Interlocking Theoretical Approaches. New York, NY : Oxford University Press

Center for Substance Abuse Treatment (U.S.). (2012). Substance use disorder treatment for

people with physical and cognitive disabilities. Rockville, MD: U.S. Department of Health and Human Services.

Tuten, L. M., & American Psychological Association. (2012). Reinforcement-based treatment

for substance use disorders: A comprehensive behavioral approach. Washington, DC: American Psychological Association.Kelley, M. L., Bravo, A. J., Braitman, A. L., Lawless, A. K., & Lawrence, H. R. (2016).

Behavioral Couples Treatment for Substance Use Disorder: Secondary Effects on the Reduction of Risk for Child Abuse. Journal of Substance Abuse Treatment, 62, 10-19.


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