Presentations 2007 - 2008

May 15, 2008

Cognitive Behavioral Therapy and Sober Living Treatment

The presentation will cover how cognitive behavioral therapy addresses several critical tasks that are essential to successful substance abuse treatment.  It will examine how the sober-living model mirrors the basic philosophies of cognitive behavioral therapy.

How does the Sober-Living Model (as an extension of primary treatment) mirror the basic philosophies of Cognitive Behavioral Therapy?

• Foster the motivation for abstinence. An important technique used to enhance the patient's motivation to stop cocaine use is to do a decisional analysis which clarifies what the individual stands to lose or gain by continued cocaine use.
• Teach coping skills. This is the core of CBT - to help patients recognize the high-risk situations in which they are most likely to use substances and to develop other, more effective means of coping with them.
• Change reinforcement contingencies. By the time treatment is sought, many patients spend most of their time acquiring, using, and recovering from cocaine use to the exclusion of other experiences and rewards. In CBT, the focus is on identifying and reducing habits associated with drug-using lifestyle by substituting more enduring, positive activities and rewards.
• Foster management of painful affects. Skills training also focuses on techniques to recognize and cope with urges to use cocaine; this is an excellent model for helping patients learn to tolerate other strong affects such as depression and anger.
• Improve interpersonal functioning and enhance social supports. CBT includes training in a number of important interpersonal skills and strategies to help patients expand their social support networks and build enduring, drug-free relationships.

CBT Treatment is usually delivered on an outpatient basis for several reasons making it very congruent with the long-term sober-living model currently used for addiction treatment:

• CBT focuses on understanding the determinants of substance use, and this is best done in the context of the patient's day-to-day life. By understanding who the patients are, where they live, and how they spend their time, therapists can develop more elaborate functional analyses.
• Skills training is most effective when patients have an opportunity to practice new skills and approaches within the context of their daily routine, learn what does and does not work for them, and discuss new strategies with the therapist.

Compatibility with Adjunctive Treatments

CBT is highly compatible with a variety of other treatments designed to address a range of comorbid problems and severities of cocaine abuse:
Pharmacotherapy for cocaine use and/or concurrent psychiatric disorders
Self-help groups such as Cocaine Anonymous (CA) and Alcoholics Anonymous (AA)
Family and couples therapy
Vocational counselling, parenting skills, and so on When CBT is provided as part of a larger treatment package, it is essential for the CBT therapist to maintain close and regular contact with other treatment providers.

Harry A. O'Hayon, PG Dip. in CBT, M.Sc. (c) in CBT, R.P.C.
Harry O’Hayon is a Registered Professional Counsellor licensed with the Canadian Professional Association of Counsellors and a Cognitive Behavioral Psychotherapist (CBP). Harry works with individuals, couples, families and youth and is the clinical coordinator of trauma recovery groups utilizing an evidence-based Cognitive Behavioral Therapy (CBT) treatment.  Harry has several years experience in the treatment of addiction as well as mood and anxiety disorders, working in both out-patient and residential facilities. His experience includes developing and facilitating family programs featuring presentations on: how addiction impacts the family; codependency; understanding anger; the language of emotions and recovery & relapse prevention.

Harry draws from a wide range of therapeutic modalities in his work including: CBT; Systemic Therapy; Dialectical Behavioral Therapy; Acceptance and Commitment Therapy; Mindfulness-based Cognitive Therapy and Integrative Psychotherapy.