A Cognitive-Behavioral Approach to Substance Abuse Treatment: Canada Embraces Social Learning Concept in Treatment of Substance Abuse

Article excerpt

Perspectives on substance use and abuse have evolved over time, reflecting shifts in cultural, societal and professional standards. The last few decades have witnessed a transition from viewing substance abusers as morally bankrupt to attributing the problem to either a chronic and progressive disease or to a learned behavior with significant negative consequences.

While treating substance abuse as a disease rather than a moral deficiency has its proponents, this model has been characterized by a lack of substantive theory and supporting research. However, preliminary research has confirmed the effectiveness of behavioral and cognitive-behavioral techniques on substance abusers in correctional settings.

The concept of social learning is of pivotal importance in forming the theoretical base for correctional interventions that make use of behavioral and cognitive-behavioral techniques. The social learning perspective holds that complex behaviors such as the use of alcohol and other drugs are largely the product of prior experiences. This model holds that global cognitive processes, such as thoughts and emotions, have a significant impact on behavior. The individual's ability to actively modify and control addictive behavior is at the heart of the treatment component of this approach.

Results from numerous meta-analytic reviews of the adult and juvenile correctional treatment literature have repeatedly underscored the efficacy of structured intervention approaches that are built around behavioral and cognitive-behavioral techniques in modifying offenders' criminal behavior. Moreover, studies examining the impact of cognitive-behavioral intervention within the context of substance-abusing offenders also have yielded positive results.

Taken together, research has established that cognitive-behavioral techniques are a key component to correctional treatment. Intervention that is designed to teach substance-abusing offenders skills to successfully modify their behavior stand the best chance of reducing future substance use. Given that substance abuse is a primary criminogenic factor, the provision of effective treatment to offenders during incarceration and following release is critical for offenders' successful reintegration into society.

Behavioral Intervention

Rutgers University researcher Fred Rotgers points out that there are three principle components to the process of providing behavioral intervention: assessment, skills training and relapse prevention. Structured assessment that integrates information from a variety of sources, including offender self-reporting, is the starting point for the process of developing and delivering a treatment plan. However, not all individuals manifest the same severity of substance abuse problems. As opposed to conceptualizing substance abuse problems in an all-or-nothing manner, recent research with offenders complements noncorrectional research, which demonstrates that offenders vary widely in terms of the severity of their use of a variety of illicit substances. In addition, the impact of substance abuse on a range of life areas such as employment, family and marital relations, educational level and criminal history increases dramatically as a direct function of problem severity.

Following the clear identification of the offenders' treatment needs, intervention incorporates the use of a variety of cognitive-behavioral modalities to skills, such as assertion, problem-solving and coping skills, and structured relapse prevention, that are vital to successful modification of problematic behavior both during the course of treatment and following the close of an individual's involvement in the treatment process.

Canada's Approach

The Correctional Service of Canada (CSC) provides a variety of treatment and program services that target criminogenic factors, based on exhaustive reviews of effective treatment models. CSC's systemwide treatment model has evolved in response to the vast need posed by the majority of offenders in the system for which alcohol and drugs are directly related to their criminal behavior. …