1. Sheila Specker, MD American Board of Addiction Medicine Foundation
Cognitive Behavioral Therapy for the Treatment of Substance Use Disorders
Sheila Specker, MD
American Board of Addiction Medicine Foundation

2. Summary of Module Contents
Slide deck : N = 38
Notes for lecturer: not available
Handout materials: practice exercises and instructions
Annotated bibliography: available
Test questions: 4 pretest, 4 post-test
Other: patient brochure with resources, webinar link

3. Cognitive Behavioral Therapy for Substance Use Disorders
CBT is skill based and effective
Challenging thoughts about use changes behavior
Key point: CBT principles are very applicable to SUD’s
3 main recommendations:
Use CBT practice skills, functional analysis, relapse prevention
Individualize CBT
Add pharmacotherapies to CBT

4. CBT Principles Apply to SUD
Short-term application (weeks)
Studied in rigorous clinical trials
Structured, specific, goal oriented
Focuses on immediate problems
Individualized (including internet based)

5. Example of Topic: Self-Monitoring Record (Functional Behavioral Analysis)
Trigger
(Person, Place, Thing, Idea, Institution)
“_____ sets me up and then I want to use”
Thoughts and Feelings
“I was feeling _____”
“I was thinking _____”
Behavior
“After the trigger
And feelings, I (did)
________”
Positive Consequences
This positive thing happened
Negative Consequences
This negative thing happened

6. Recommendation #1
Use CBT principles of practice skills, functional analysis, relapse prevention in treating alcohol use disorders in practice
SORT level = A
References:
Ball, SA, et al. Addictive Behavior, 2007, 32(6),
Dutra, L, et al. American Journal of Psychiatry, 2008, 165(2),
Whitlock, E, et al. Annals of Internal Medicine, 2004, 140 (7) ,

7. Recommendation #2 Individualize CBT for topic, session #,
in-person/internet (SORT A)
Example of topic choices
Functional analysis,
Coping with cravings,
Managing thoughts about drinking,
Problem solving,
Drinking/drug refusal skills,
Coping with high risk situations,
Seemingly irrelevant decisions
Reference
Litt et al. Addiction, 2009, 104,

8. Dissemination Strategy
Didactics
Seminar series for psychiatry residents and addiction fellows (done, ongoing)
Grand Rounds, University of MN Psychiatry (done)
CME presentation: statewide Minnesota Psychiatric Society (Nov planned)
Patient brochure (designed)
ABAM MOC (planning)
Webinar (planning)
Manuscript for publication (discussing)