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The Science Behind Behavioral Therapies

Choosing the right rehab center to treat your addiction is no easy task. However, numerous drug and alcohol treatment facilities offer cognitive behavioral therapy and dialectical behavioral therapy, which have been proven effective by various researchers and clinicians from around the world.

Addiction is a chronic brain disease that affects a person’s motivation, memory and reward circuit.

Drugs and alcohol increase dopamine levels, creating an intense high that causes people to constantly crave the substance. Over time, the brain adjusts to the dopamine levels, reducing the euphoric effects. This often results in heavier drug use.

Addiction can be successfully treated and managed. Rehab centers across the country offer evidence-based treatment for those with substance use disorders. These treatment approaches often involve behavioral therapies that have been rigorously tested and are proven to help individuals overcome addiction.

Cognitive-Behavioral Therapy

Cognitive-behavioral therapy (CBT) aims to help people identify, understand and change behaviors by altering their perceptions. Patients learn the underlying causes of their substance use disorder and strategies to cope with these problems. These techniques often involve learning to identify triggers, manage cravings and recognize high-risk situations.

CBT allows patients to be involved in their own recovery. They may read about their substance use issues, keep records of their appointments and even complete homework assignments related to the lessons taught during therapy.

This treatment approach has proven effective for a variety of illnesses, including:

More specifically, CBT can be used to treat addictions to alcohol, marijuana, cocaine, methamphetamine and nicotine.

The Science Behind CBT

Various studies have shown that CBT modifies brain activity.

A 2004 study published in the Archives of General Psychiatry indicated that CBT modifies the limbic system of the brain, which affects emotion, motivation and long-term memory. This treatment technique can help reduce problems associated with drug addiction, including angry outbursts and memory loss.

CBT also affects the brain’s cortical region, linked to attention, perception and awareness, the study found.

In 2009, researchers evaluated multiple studies that used neuroimaging techniques to investigate changes in brain activity in CBT patients with anxiety disorders. The review, published in the Journal of Neuropsychiatry and Clinical Neurosciences, found this therapy approach changes circuits in the brain that affect dysfunctional neural activity, including negative thoughts and fear.

“The literature shows that many mental disorders are involved with the inability to control fear and difficulty in regulating negative emotions,” the study stated.

A 2016 study published in the journal Translational Psychiatry made similar discoveries. Researchers at several Swedish universities studied MRI scans before and after CBT. They confirmed that CBT decreases volume and activity in the brain’s temporal lobes — specifically the amygdala. This part of the brain regulates emotional behavior and is also part of the limbic system.

Researchers discovered a difference in brain function after just nine weeks of therapy.

“The greater the improvement we saw in the patients, the smaller the size of their amygdalae,” co-author Kristoffer Mansson, a doctoral student at Linköping University, said in a press release. “Several studies have reported that certain areas of the brain differ between patients with and without anxiety disorders. We’ve shown that the patients can improve in nine weeks — and that this leads to structural differences in their brains.”

How Effective is CBT?

CBT is an empirically based form of therapy that examines the origin of addiction problems and teaches patients how to overcome them. It is one of the most popular treatment techniques available. But does it work?

A 2013 study published in Cognitive Therapy and Research measured the effectiveness of CBT using 269 meta-analyses. The evaluations covered CBT involving various illnesses, including personality disorders, psychotic disorders and substance use disorders.

The study found evidence proving the efficacy of CBT among individuals with addiction. This treatment approach was very successful in treating marijuana and nicotine addiction. However, CBT proved less effective in treating opioid and alcohol addiction.

Those who attended multiple sessions had a greater rate of success than those who participated in a single session, according to the study.

Other research has shown that CBT helps individuals with alcohol addiction. Researchers at Boston University found that transdiagnostic CBT was more effective in reducing heavy drinking in people with anxiety and alcoholism than progressive muscle relaxation therapy, a treatment technique used to ease tension. Transdiagnostic CBT applies the same treatment principals to all mental disorders, rather than specific techniques to certain illnesses.

Using medication in conjunction with CBT did not reduce alcohol consumption, according to Boston University researchers.

“This study points to the importance of behavioral approaches to decrease heavy drinking through strategies to improve emotional regulation,” Dr. Domenic Ciraulo, chair of psychiatry at Boston University School of Medicine, said in a press release.

Dialectical Behavior Therapy

Dialectical behavior therapy (DBT) is a modified version of CBT primarily used for patients battling suicidal thoughts and self-injurious behaviors. This form of treatment involves individual psychotherapy, group skills training and phone consultations.

DBT is often used to treat:

DBT primarily differs from CBT in that DBT encourages patients to learn to accept stressing thoughts, feelings and behaviors rather than reject them. Therapists aim to find a balance between acceptance and change to help the patient overcome their problems.

The Science Behind DBT

Studies indicate that DBT, like CBT, has neurobiological effects on the brain.

A 2014 study published in the Journal of Psychiatric Research tested the effect DBT had on individuals with borderline personality disorder, an illness that has been linked to drug and alcohol abuse. In the study, researchers took MRI scans of patients as they viewed unpleasant, neutral and pleasant photographs. Scans were conducted before and after DBT treatment.

The study found that DBT reduces activity in the amygdala, a part of the brain that is often disturbed in patients with borderline personality disorder. By reducing amygdala activity, DBT improves emotional behavioral health.

In a 2016 study funded by the American Foundation for Suicide Prevention, Dr. Anthony Ruocco and colleagues investigated DBT’s effect on brain activity by evaluating 29 borderline personality disorder patients with self-harming behaviors. Participants underwent brain image scanning while completing a computer task before and after DBT therapy.

Ruocco saw a change in brain activity after DBT treatment, and the therapy reduced self-harm behavior. After treatment, patients showed increased activity in the prefrontal cortex, a part of the brain that controls emotional and behavioral health.

How Effective is DBT?

DBT helps individuals respond to difficult emotions in a more adaptive way. This form of treatment has also proven to reduce suicidal episodes and psychiatric hospitalizations, according to a report by Yale University.

Numerous studies have measured the effectiveness of DBT.

A 2007 study published in the Journal of the American Academy of Child & Adolescent Psychiatry tested DBT methods on adolescents with bipolar disorder. Nine of 10 patients completed treatment. At the conclusion of therapy, patients saw a decrease in self-injurious behavior, suicidality and symptoms of depression.

“Dialectical behavior therapy may offer promise as an approach to the psychosocial treatment of adolescent bipolar disorder,” the study authors concluded.

A study published in the journal Behavior Therapy studied the efficacy of DBT in women veterans with borderline personality disorder. Researchers found DBT to be effective in reducing thoughts of hopelessness, depression and angry outbursts.

The findings suggested that DBT can be effective in treating other groups of patients, including those without suicidal or self-injurious behavior. In a randomized clinical trial cited by the study authors, researchers found that DBT is more effective than treatment as usual for drug-dependent women with borderline personality disorder.

A 2006 study on DBT found this method of treatment helpful for people suffering from substance use disorders, binge eating disorders or depression. Researchers also found that this treatment method helped reduce suicide attempts, emergency room visits and parasuicidal behavior such as self-harm.

A 2015 study published in the journal Addictive Behaviors used DBT in conjunction with cultural, spiritual and traditional practices to treat 229 adolescents at an inpatient rehab facility. The results showed 96 percent of adolescents improved or recovered from their substance use disorders over time.

This treatment method works for people suffering from eating disorders as well. A 2001 study found that DBT significantly decreased symptoms of bulimia among women. These symptoms include binge and purge behaviors.

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