Advances in Cognitive-Behavioral Therapy (CBT) for Addictive Disorders: Focus on Content and Process with Bruce S. Liese, PhD, ABPP-Slides

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Dr. Bruce S. Liese's presentation on advances in Cognitive Behavioral Therapy (CBT) for addictive disorders focuses on evolving therapy content and processes. It highlights the transition from the traditional rigid approaches of the 1990s to more nuanced and personalized methodologies of today. In the past, addiction treatments focused heavily on abstinence and relapse prevention, with the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) maintaining dichotomous categorization for substance issues. Stereotypes and stigmatization were prevalent, and early CBT was often misunderstood as superficial and mechanistic.<br /><br />Today, the approach to addictions has shifted, influenced by societal changes such as the opioid crisis and evolving understandings captured in DSM-5. The latter recognizes behavioral addiction and emphasizes a continuum of addiction severity. Now, therapy encourages individualized goals, with interventions like motivational interviewing fostering collaborative therapy processes.<br /><br />Modern CBT tackles common errors such as neglecting functional analysis and over-reliance on cognitive-behavioral alliances. It stresses flexibility while focusing on co-occurring mental health issues and comprehensive case conceptualizations incorporating interpersonal, cultural, and motivational factors. Liese advocates that CBT's framework should not fit a "one size fits all" model but should be tailored to individual needs, whether through addressing cognitive distortions or developing skills like mindfulness.<br /><br />The presentation also delves into specific CBT techniques such as functional analysis, motivational interviewing, and mindfulness, emphasizing that interventions should be adaptable and collaborative. Cognitive science concepts like cognitive bias, executive functioning, and various thinking systems further inform CBT methodologies, enhancing therapeutic effectiveness. Thus, a comprehensive understanding of these elements is essential for addressing complex addiction and co-morbid challenges effectively.

Keywords

Cognitive Behavioral Therapy

addictive disorders

personalized methodologies

DSM-5

motivational interviewing

functional analysis

cognitive distortions

mindfulness

cognitive bias

co-occurring mental health

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