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Cbt and Addictions

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Cognitive Behavioral Therapy and Addictions
Susan Folger
COUN 503 B08
Liberty University
February 19, 2014

Introduction The abuse of substances by adolescents is a major social problem that places a heavy burden on individuals, families, schools, medical systems and legal systems. Cognitive behavioral therapy puts its focus on the underlying cognitive processes and environmental cues that affect developmental issues and substance abuse. To address the problem of substance abuse relapse, “a secondary analysis involving administration of the Adolescent Relapse Coping Questionnaire (ARCQ) and the Global Appraisal of Individual Needs (GAIN) was conducted to understand adolescent’s cognitive-behavioral coping skills in relation to substance abuse relapse” (Hunter, 2006). The ARCQ is a three-part instrument that was designed to be used with adolescent substance abusers. This particular instrument assesses coping and appraisal in situations “where there is a high risk of relapse” (Hunter, 2006). The ARCQ has three factors that are made up of different coping strategies. There are 3 different factors involved. Factor 1: “cognitive behavioral strategies such as developing a plan and following through” (Hunter, 2006). Factor 2: “self-critical statements for example, blaming or criticizing” (Hunter, 2006). Factor 3: “abstinence-focused strategies such as attending meetings of Narcotics Anonymous or Alcoholics Anonymous” (Hunter, 2006). This particular instrument focuses on substance abuse, the negative consequences that are associated with substance abuse and the different triggers that can lead to relapse. The ARCQ was designed for adolescents and is frequently used in research and has proven to have good psychometric validity. Another instrument used is the Global Appraisal of Individual Needs (GAIN). This particular instrument assesses information on substance use and demographics and was used in this particular study “to examine any potential differences among three age groups (15, 16, and 17) of adolescents” (Hunter, 2006). The GAIN, “which also was designed for use with adolescents, has demonstrated good reliability and validity. The purpose of this study was to examine the relationship between cognitive-behavioral coping strategies utilized in Factor 1 on the ARCQ and the rate of substance abuse relapse in adolescents between the ages of 15-17 at 3,6,9, and 12 months after the start of cognitive behavioral therapy. It was found that the larger sample size provided a higher degree of construct validity than in past studies that used smaller sample sizes. Both the ARCQ and the GAIN “have been published frequently and have demonstrated good psychometric validity and reliability” (Hunter, 2006). Statistical power analyses “suggested that a sample size of 177 participants resulted in the ability to detect a correlation as low as r=0.21” (Hunter, 2006). The Hispanic population represented the majority of adolescents in this sample at 46.1%. A limitation of this study is that if “focused more on the variables of age and cognitive-behavioral coping strategies in Factor 1 on the ARCQ rather than on culture or other demographic factors” (Hunter, 2006). The cultural component “may also be a limitation to external validity in that the makeup of the population may make it difficult to generalize the findings to the larger population” (Hunter, 2006). Another limitation of this study is that the ARCQ measures only the cognitive behavioral aspects of coping and not the specific types of cultural coping strategies that may be more relevant to gender, race, and ethnicity. The researcher considered the fact that adolescent substance abuse is many times associated with other conditions, such as “depression, anxiety, conduct disorder, attention-deficient hyperactivity disorder, stress and adjustment disorders, reactive attachment disorder and oppositional defiant disorder”(Hunter, 2006). It has been shown through research that “over 75% of adolescents admitted to treatment present with one or more of these comorbid conditions” (Hunter, 2006). A strength of this study “was that attrition was not a confounding variable because the research was a secondary analysis” (Hunter, 2006).
Summary
Substance abuse is a growing health concern for our society today. 90% of adults who report substance abuse initiated use before the age of 18. 50% reported initial use before the age of 15. This research study was conducted in Arizona which explains the high rate of Hispanic participants. This study “is expected to contribute significantly to information needed by clinicians to design comprehensive treatment programs” (Hunter, 2006). By “increasing the effectiveness of treatment, the affected adolescents, their families and society will receive vast benefits” (Hunter, 2006).

Reference
Hunter, K.A. (2006). The relationship between cognitive behavioral coping skills and substance Abuse in adolescents. (Order No. 3200712; Walden University). Proquest Dissertations and Theses, 114-114.p. Retrieved from http://search.proquest.com/docview/304937202” Accountid=12085. (304937202).

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