Cognitive Behavior Therapy and Using Videos to Help Addiction Recovery

Drug addiction is a serious mental health and medical issue that affects millions of people worldwide. It can have devastating consequences on one’s health, relationships, career, and overall well-being, and in some cases, as has been the case with opioids, fentanyl, and other major drugs in recent times, can lead to death. While addiction is complex with biological and environmental factors playing a role, one psychological therapy approach -cognitive behavior therapy (CBT) has proven to be consistently effective in helping people overcome addictive behaviors and stay in recovery. This is particularly true when combined with other support processes such as targeted educational videos, for example, and in this brief article we will describe why this is the case.

What is Cognitive Behavior Therapy?

Cognitive behavior therapy is a form of psychotherapy that focuses on changing dysfunctional thinking patterns and behaviors. At the core of CBT is the idea that our internal thoughts dictate our emotions or feelings and actions. When we have irrational or unhelpful thoughts (cognitions) it leads to negative emotional consequences and maladaptive behaviors. CBT helps people identify these automatic thoughts, evaluate whether they are realistic, and replace them with more balanced perspectives.

Some key aspects of CBT include:

• Monitoring thoughts, feelings, and behaviors related to addiction and high-risk situations
• Learning coping strategies to deal with cravings and avoid relapse
• Challenging cognitive distortions that maintain substance use
• Improving problem-solving skills and self-efficacy
• Building a balanced lifestyle not revolving around drugs
• Practicing new behaviors and thought patterns through practice in a ‘home’ setting

How CBT Applies to Addiction Recovery

CBT is highly effective for addiction for several reasons. People struggling with substance abuse often have cognitive distortions that downplay the risks of use and magnify perceived benefits. They may use “all-or-nothing” or “black-and-white” thinking when it comes to abstinence versus relapse. CBT often helps individuals recognize these irrational thoughts and thought patterns that perpetuate addictive behaviors.

For example, someone recovering from alcoholism may think “One drink won’t hurt, I can control it.” Or “If I mess up once, I might as well keep using, as I’ve already failed.” CBT would challenge these thoughts and offer more balanced perspectives like “Slip-ups happen in recovery, but I can learn from mistakes and get back on track” or “Moderate use leads back to addiction for me — my goal is long-term sobriety or “sober living”.

In addition to the above, substance abusers commonly have poor coping skills and see drugs as their only way to deal with stress, emotions, or social situations. CBT teaches healthy stress management, a variety of communication techniques, and lifestyle balance as alternatives to using. It also helps people recognize and avoid high-risk people, places, and things that can trigger cravings and relapse.

The behavioral aspects of CBT, such as keeping a daily thought record or journal, role-playing difficult scenarios, and completing other ‘homework’ practices, help individuals change ingrained patterns of thinking and acting. By practicing new coping strategies and replacing addictive behaviors, people are better equipped to maintain recovery over the long-term.

The Role of Educational/Guidance Videos

While CBT provides a framework and strategies, educational/guidance videos can enhance treatment by demonstrating concepts and skills and even ‘model’ new behaviors and practices that may be beneficial. Short, targeted videos are often an engaging medium to supplement in-person therapy or self-guided learning, especially between face-to-face interactions. They can bring CBT principles to life through real-world examples and make complex topics more accessible.

Some ways videos can support CBT for addiction include:

• Modeling cognitive restructuring exercises — Videos can depict someone identifying automatic thoughts, evaluating evidence, and substituting alternative perspectives related to substance use.
• Demonstrating coping skills — Videos show effective stress management, communication, problem-solving, and refusal skills being practiced in high-risk situations.
• Highlighting cognitive distortions — Specific cognitive distortions like all-or-nothing thinking are explained and examples are given to help people recognize these patterns.
• Illustrating relapse prevention plans — Videos can walk people through developing a comprehensive relapse prevention plan, including identifying triggers, early warning signs, and coping strategies.
• Normalizing recovery challenges — Stories from people in long-term recovery address common setbacks to reassure viewers struggling is a normal part of the process.
• Reinforcing at-home practice — Videos provide prompts for behavioral experiments, role plays, and other practices that people can do at home to reinforce skills learned in therapy.

Used together, CBT (applied by mental health professionals, case managers, and the individual) and targeted videos create a multi-modal treatment approach, especially when sound community support is also available. Videos make abstract CBT principles more concrete while therapy provides individualized guidance, feedback, and accountability. The combination empowers people with knowledge and skills to help overcome addiction and maintain long-term sobriety.

Evidence of Effectiveness

Numerous research studies, in the last few years, have demonstrated the efficacy of CBT for treating substance use disorders. A meta-analysis published in the Journal of Consulting and Clinical Psychology analyzed 27 randomized controlled trials of CBT for various addictions. It found CBT was significantly more effective than no treatment or other individual active treatments in reducing substance use and helping people achieve and sustain abstinence.

Specifically for drug addiction, a review in the journal Drug and Alcohol Dependence looked at 19 controlled trials of CBT for cocaine, opiate, or cannabis dependence. The analysis concluded CBT significantly improved treatment retention and reduced drug use post-treatment compared to no treatment or other interventions.

While few studies have directly assessed educational videos as an adjunct to CBT for addiction, research on videos for other mental health issues also provides promising evidence. One study in the Journal of Medical Internet Research found a CBT-based video program helped reduce depression symptoms when paired with brief therapist support. Videos are therefore likely to enhance standard CBT by improving learning, accessibility, and treatment adherence, especially when they are used in combination with sound case assessment and management and as much useful family and community support as can be made usefully available.

Conclusion

In summary, cognitive behavior therapy has been shown to be a highly effective treatment for overcoming drug addiction and maintaining long-term recovery. By helping individuals identify and modify dysfunctional thought and behavior patterns, CBT equips people in recovery with lifelong coping skills. When combined with well-designed and targeted educational videos, and as much community support as necessary in each individual situation, CBT principles can be demonstrated and reinforced to enhance the treatment process. The multi-modal approach of targeted case-by case assessment, and readily accessible community support, in-person CBT therapy supplemented by videos can empower people to overcome addiction and live fulfilling substance-free lives. With continued research, CBT and technology-based tools show promise for dramatically improving addiction treatment outcomes.

This article was written by Jon Warner, Executive Chair of Citizen Health Strategies (CHS). CHS optimizes the end-to-end care experience with advisory, consulting, and product-building services to help deliver the Quintuple Aim — enabling better, faster, and more personalized well and sick care for all.