Alcohol Rehabilitation and Psychotherapy – at Cape Town Rehabilitation Centres

Psychotherapy and Alcohol Rehabilitation – at Cape Town Rehabilitation Centres


The two most common therapeutic approaches to alcohol rehabilitation include:


• Cognitive Behavioural Therapy (CBT)

• Dialectical Behavioural Therapy (DBT)


This article will give you all you need to know about Cognitive Behavioural Therapy (CBT), and Dialectical Behavioural Therapy (DBT), in relation to alcohol rehabilitation.



Cognitive Behavioural Therapy – An introduction to CBT and Alcohol Rehabilitation


CBT is a structured and problem-focused therapy approach that is highly effective in treating many mental health issues, including addiction. CBT therapists view mental health problems, as exaggerations of normal processes that largely result from disturbances in our thought processes. CBT is based on the idea that our thoughts, feelings, bodily sensations, and actions are connected and influence each other. This means that how you think affects how you feel and behave and vice versa.



Cognitive-behavioural coping skills treatment is a short-term, focused therapeutic approach to helping alcoholism or drug-dependent clients achieve abstinence and recovery. The treatment approach does this by using the same learning processes you used to develop alcohol dependence in the first place.



What is it?


CBT is based on the idea that feelings and behaviours are caused by a person’s thoughts, not external stimuli like people, situations and events. While you may not always be able to change your circumstances, you can change what you think about them, which in turn helps you to change how you feel and behave.



Alcohol Rehabilitation- the goal of CBT is to:


• Teach you to recognize situations in which you are most likely to drink alcohol

• Avoid these circumstance where possible

• Cope with other problems and behaviours which may lead to your substance use



According to CBT theory, your interpretation of life events is more important than the actual events themselves. In other words, it is not a particular situation that causes you to feel emotional distress; it is your interpretation or view of that situation that causes psychological pain and suffering. This is because your thoughts have a powerful effect on your emotions. This is targeted in rehabilitation in order to uncover and address the thoughts that cause / trigger your desire to use alcohol.



Alcohol Rehabilitation - Triggers and feelings triangle




Rehabilitation focuses on addressing how you interpret the situation and therefore how you will feel about it. For example: if you interpret a situation in a neutral or positive light, you will probably feel calm or experience positive emotions, and these feelings will influence how you react. Conversely, if you interpret the same situation negatively, you might experience negative emotions and behave in a different way altogether.
Alcohol rehabilitation and the thoughts – feelings – behaviours model work well to address and the way they influence each other and more importantly, how to use this in the treatment for rehabilitation.



For example: Imagine you are walking past one of your favourite local bars on your way home from your friend’s house. You hear people laughing, glasses clinking and music (the event or situation). You think you see someone you know sitting in the bar having a drink and you begin to think it wouldn’t be such a bad idea to just have one drink (Your thought / interpretation). You begin to feel excited and anxious about that first sip (emotional response), your heart beats faster (your bodily response) and you start walking towards the bar (your behaviour).


– This example highlights the thoughts, feelings and behaviours that rehabilitation emphasizes, processes and changes.

– CBT works towards restructuring your thought patterns about alcohol use and then addresses how to change and interrupt the cycle in order to establish healthier feelings and behaviours



Now imagine that you are walking home from your friend’s house and you pass your local bar, hearing the cheerful laughter, music and the clinking of glasses (The same event or situation). You take a closer look and think that the bar is filled with strangers and that you are not thirsty and don’t really feel like a drink (Your thought / interpretation). You feel calm (emotional response), and relaxed (your bodily response) and you carry on walking home (your behaviour).



These examples demonstrate how rehabilitation and CBT can assist you to be able to be in the same situation as someone else and experience it totally differently because of the way you interpret it. In other words, CBT helps you to process the meaning you give to your experiences (your interpretation) and how this largely determines your feelings about the events in your life. We are all constantly interpreting what is going on around us and forming beliefs about ourselves and other as well as the world we live in. sometimes these beliefs are inaccurate and distressing and can lead to unhelpful ways of behaving.



Alcohol Rehabilitation and choosing alternative possibilities for thinking and behaving:



CBT sessions will encourage you to begin exploring different approaches to how you think and behave, whilst linking this to your rehabilitation program. You will develop new skills to regulate your mood, manage your symptoms, improve your relationships, and become more effective in your journey to recovery.



• Setting realistic goals

• Learning how to solve problems effectively

• Learning how to manage stress and anxiety through relaxation techniques, coping self-talk and behaviour experiments

• Identifying triggering situations

• Identifying and challenging negative thoughts and beliefs

• Keeping track of feelings, thoughts and behaviours to make it easier to identify and change them

• Identifying and engaging in enjoyable activities




Alcohol Rehabilitation - Skills




Dialectical Behaviour Therapy – an introduction to BDT and Alcohol Rehabilitation


Dialectical Behaviour Therapy (DBT) is a treatment that was created by Marsha Linehan. One of the main reasons DBT will be effective in helping people with rehabilitation is because it helps people learn to manage their overwhelming emotions and cravings in more effective ways. DBT is effective in helping people learn to handle distress in healthier ways without losing control.



What is Dialectical Behaviour Therapy? A Definition:


DBT is a type of cognitive behavioural therapy that focuses on the psychosocial aspects of therapy, emphasizing the importance of a collaborative relationship, support for the client, and the development of skills for dealing with highly emotional situations.



DBT teaches skills such as mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness. These skills are taught during rehabilitation in order assist you in becoming more aware of yourself and your experiences and increasing mindfulness in order to help you cope with relationships, cravings and general functioning.



DBT vs. CBT: How do they differ in Alcohol Rehabilitation?


Although DBT and CBT sound similar, there are distinct features that set them apart. DBT, like CBT, focuses on helping people address their dysfunctional thinking and behaviours through modification of their thought patterns and, through changing their thoughts as well as their behaviour. However, CBT in rehabilitation is usually confined to a limited period of time and is often applied with one or two specific goals in mind. On the other hand, DBT narrows the focus of rehabilitation to the psychosocial aspects of daily life. Many people experience difficulties with their behaviours and thought patterns, but these struggles are often at their most disruptive in the context of relationships with others. The emphasis in DBT is on how you relate to others in your life as well as how to understand, regulate and communicate your emotions in an effective and mindful way.



Alcohol Rehabilitation and Observing Urges using DBT


The DBT skills program in rehabilitation focuses on urges and cravings, as they are likely to continue for some time after prolonged alcohol abuse or drug use. They can be triggered by certain situations, smell, tastes, moods and so on. While it is useful to learn about these it is not always possible to avoid triggers and to stop them from developing. Keeping in mind that having a craving is not the same as wanting to use/drink, let alone using/drinking alcohol, it is important to attend to a craving to prevent it going further.



DBT programs observe that drug urges are part of the “what” mindfulness skills. You can compare your urges or craving to


• Clouds in the sky that fly past

• Boxes coming down a conveyer belt

• Waves that build up, crest, then diminish over time




Alcohol Rehabilitation - Wave




Alcohol Rehabilitation - Summary of Skills




How DBT and Alcohol Rehabilitation works:


DBT is a short-term and research-based therapeutic model that focuses on helping people to manage emotions that may be intense and painful. Often, alcohol may be used as a method of coping, or self-medicating, emotions that are difficult, such as anxiety and depression. Rehabilitation acknowledges that many people use alcohol to temporarily soothe troubling thoughts and serve as a way to escape from reality. There is often a lot of guilt and shame that accompanies addiction, and DBT can help individuals to accept themselves for who they are and move forward in a positive manner. Rehabilitation aims to increase self-acceptance as this can heighten self-esteem and motivation for positive change.



DBT can help people to recognize intense emotions, how to accept some of them as a part of life, and how to change ones that lead to negative actions. A combination of alcohol rehabilitation and DBT allow individuals to learn how to accept themselves for who they are and develop took for dealing with difficult emotions and managing stress. Painful emotions are part of life, and DBT can help to see this and learn to cope with them in a healthier manner.


DBT and CBT as effective therapeutic modalities for alcohol rehabilitation


DBT and CBT are widely used in the treatment of alcohol rehabilitation and are effective in assisting people along their journey to recovery and a better, more prosperous future. They work by identifying faulty thoughts and working towards changing them in order to change and shift your feelings and behaviours. DBT and CBT are widely researched and acknowledged and have been proven to help with the treatment of alcohol rehabilitation. The practical skills and tools will equip you long after you leave rehabilitation and are skills that you can always practice and use in your day to day life, allowing you to lead the life you want!



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