Cognitive approaches to SUD-Rx

25th November 2010
The main theoretical basis of these approaches is in SocialCognitiveTheory.

Strongly held beliefs about Cannabis ("It is harmless" or "Without it I am much more aggressive", etc) may take the form of Implicit Core Beliefs and threaten a young person's motivation or the application of planned change behaviours.

The Cognitive Behavioural approach is similar to Motivational Work in that direct confrontation is avoided (Roll with Resistance), but there is slightly more room for gentle challenge.

In keeping with the Cognitive therapist stance (see CognitiveBehavioural for SUD-Rx) the approach towards a particular cognition is:

Identify the cognitions:

Via a joint exploration of the young person's Thinking the client and therapist seek to uncover the Implicit Core Beliefs that underpin a young person's thinking and influence Feeling and Behaviour.

Externalise the problem:

Consider a specific cognition (for instance "Without drugs I am totally unlovable.") as separate from the thinker. Note this is dirently related to the ideas about Psychic equivalence from Mentalization-based approaches:
  • "What would an observer from a distance see as the effect on you when this particular thought comes into your mind?"
  • "Would it seem to make it more or less likely that you would use cannabis in the hours after it had been in your mind?"

Design experiments to test these (dysfunctional) ideas:

  • "How could we design a test to see if this thought is true all of the time, only some of the time, or none of the time?"
  • "'TOTALLY' is a strong word - I mean if just one person still found you lovable then that wouldn't be TOTALLY, would it?"
  • "Who might we ask, or what do we think the people closest to you would say, if we did ask them whether you are 'totally unlovable'?"

Weighing Pros and Cons

This is another version of a Cognitive approach to the notion that "I don't want to change my cannabis habit."