Over the past years, there has been a significant increase and development of various evidence-based psychosocial treatment approaches for substance use disorders. The paper will focus on cognitive behavioral therapy and motivational interviewing. Cognitive behavioral therapy (CBT) is based on the learning principle and the belief that cognitive processes influence behavior. CBT comprises of different approaches that have applications in the treatment of various addictions. According to Jhanjee (2014), CBT is regarded as the efficient method for individuals suffering from alcohol abuse. Numerous studies by different scholars indicate the effectiveness of CBT in the treatment of substances such as alcohol, smoking, cannabis, amphetamines, and heroin. For instance, a study by Killen, Fortmann, Schatzberg, Arredondo, Murphy..., and Pandurangi (2008) shows how CBT was used as a treatment approach for cigarette smoking cessation. The researchers extended the eight to twelve weeks smoking cessation therapy where adults received nine weeks of open-label treatment in combination with CBT. CBT indicated favorable treatment response during twenty weeks of follow up. Men performed marginally better when assigned to CBT. Mc Carthy and O'Sullivan (2010) also show the effectiveness of CBT in the reduction of excessive drinking among Irish navy. The treatment group significantly changed their alcohol consumption levels and showed the willingness to change their drinking behaviors completely.
Motivational interviewing (MI) is a method of therapy that aims to evoke and motivate an individual to change particular behaviors (Heckman & Egleston, 2010). The effectiveness of motivational interviewing is evident in studies that involve alcohol abusing and dependent populations. Motivational interviewing is also used in the treatment of other problem behaviors such as smoking. For instance, results from a research study detailing a meta-analysis of the efficiency of motivational interviewing on smoking showed that the overall motivational interviewing intervention effect on thirty-one studies was significant (Heckman & Egleston, 2010). Motivational interviewing was also found to have a positive impact on various groups of people such pregnant mothers who engage in smoking and adolescents. Vasilaki, Hosier, and Cox (2006) assessed the effects of motivational interviewing as a strategy for treating excessive consumption of alcohol. After conducting the meta-analytic review, they discovered that motivational interviewing was a reliable method of reducing excessive drinking. The researchers also found that an eighty-seven minute period of motivational interviewing was efficient in reducing alcohol consumption among non-dependent drinkers within three months. Therefore, both cognitive behavioral theory and motivational interviewing are psychological treatment approaches relevant for the treatment of various substance use disorders such as smoking and excessive drinking.
Both motivational interviewing and cognitive behavioral therapy are utilized to treat similar complications, but they employ different approaches to reach to the affected and solve their complexities. Motivational interviewing is goal-oriented and aims to reduce the occurrence of an incident due to psychological reactions. Motivational interviewing enhances intrinsic motivation to change by assessing individual doubts. The method encourages the counselor to apply five essential techniques. Firstly, the counselor expresses empathy to the client, avoids arguments that might affect the therapeutic effect of the method, supports the individual's self-efficacy, and manages resistance without confrontation (Heckman & Egleston, 2010). Motivational interviewing applies different therapeutic strategies such as open-ended questions, listening reflectively, elicitation of client self-motivational statements, affirming, and summarizing. Motivational interviewing is also based on five fundamental principles. Motivational interviewing focuses on the individual's problems and interests that are happening presently. It focuses on face-to-face talk rather than a set of rules, involves careful responding to the client in a way that discards uncertainty and motivates the individual to change, and focuses on intrinsic motivation for change (Vasilaki, Hosier, & Cox, 2006). Motivational interviewing is suitable for adolescents, and adults and it is client-centered.
Cognitive behavioral theory (CBT) is time-limited and based on the learning principles and the assumption that cognitive processes influence behavior. CBT was designed to be quick. CBT involves six to twenty sessions, and it is problem-oriented (Rector, 2010). CBT applies to people of all ages. It focuses on here and now. CBT aims to help people understand and interpret events in their surroundings and the consequences that those activities have on their emotional experience. In CBT, individuals are taught how to identify, question, and change their thoughts. Clients are encouraged to monitor and record their thinking during situations that lead to an emotional upset. CBT is effective when used in both individual and group formats. CBT relies on the openness and the willingness of the client to respond to questions and participate in sessions.
Preferred Method and Rationale
In my opinion, I would prefer to use motivational interviewing to treat different addictions and other problematic issues. Motivational Interviewing is client-centered meaning it focuses more on the client rather than the therapist. In such a case, the client has enough room to express individual challenges. Motivational interviewing is also brief; therefore, the client will not experience fatigue while undertaking the therapy sessions. In motivational interviewing, the therapist is expected to use particular principles such as empathy, support the individual's efficacy, and manage resistance without confrontation. These principles are meant to build the confidence of the individual and change the perception of the client regarding life issues or the disorder affecting them. In other words, motivational interviewing creates an environment that is suitable for the client to become open and speak freely without feeling judged. Additionally, motivational interviewing focuses more on communication rather than techniques. In this communication, the client focuses on their behavior and evokes feelings of change towards their problems. The client also decides the best solution to pick depending on the issues they are facing. Therefore, I view motivational interviewing as the best method to treat substance use disorders and other life issues because it focuses more on the individual rather than theoretical approaches. It also motivates the individual to change the behavior. If the principles of this methodology are adhered to correctly, I believe it can result in significant and positive results.
Physicians and nurse practitioners are the key professionals qualified to conduct CBT and motivational interviewing. The role of both the physician and the nurse practitioner in both treatment techniques is to ensure that the principles, assumption, and guidelines are followed as stipulated. Physicians practicing various types of medicine such as family medicine can visit patients either at home or in the hospital. Nurse practitioners can conduct both CBT and motivational interviewing when administering drugs to patients. As an individual, there are various techniques that I can use to help the nurses and physicians coordinate the treatment. One of them is reporting cases to these professionals. Indicating that an individual or a group of individuals are suffering to a professional who can offer CBT and motivational interviewing will be the first step to ensure the target groups have access to the treatment approaches. In this target group of individuals, CBT may be used as the primary treatment approach then after CBT sessions are complete, motivational interviewing can be introduced for each member of the group. A combination of the two methods will ensure the clients have experienced the best psychological treatments for drug addictions and other social problems.
Heckman, C., & Egleston, B. (2010). Efficacy of motivational interviewing for smoking cessation: A systematic review and meta-analysis. Tob Control, 19(5): 410-416. doi:10.1136/tc.2009.033175.
Jhanjee, S. (2014). Evidence based psychosocial interventions in substance use. Indian J Psychol Med, 36(20), 112-118. doi: 10.4103/0253-7176.130960.
Killen, J., Fortmann, S., Schatzberg, A., Arredondo, C., Murphy, G., Hayward, C..., & Pandurangi, M. (2008). Extended cognitive behavior therapy for cigarette smoking cessation. Addiction, 103(8), 1381-1390. doi:10.1111/j.1360-0443.2008.02273.x.
Mc Carthy, P., & O'Sullivan, D. (2010). Efficacy of a brief cognitive behavioral therapy program to reduce excessive drinking behavior among new recruits entering the Irish navy: A pilot evaluation. Military Medicine, 175(11), 841-846.
Rector, N. (2010). Cognitive behavioral therapy. An information guide. Toronto, CA: Centre for Addiction and Mental Health.Vasilaki, E., Hosier, S., & Cox, W (2006). The efficacy of motivational interviewing as a brief intervention for excessive drinking: a meta-analytic review. Alcohol & Alcoholism, 41(3), 328-335. doi:10.1093/alcalc/agl016.
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