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How Does Mindfulness-Based Cognitive (MBCBT) Therapy Help Teens With Addiction?

Written by Evolve's Behavioral Health Content Team​:

Alyson Orcena, LMFT, Melissa Vallas, MD, Shikha Verma, MD, Ellen Bloch, LCSW, Lianne Tendler, LMFT, Megan Johnston, LMFT
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Mindfulness and Addiction Recovery

Teens diagnosed with alcohol use disorder (AUD) or substance use disorder (SUD) often need professional treatment and support to achieve sobriety and maintain long-term abstinence. If a full psychiatric evaluation administered by a mental health professional indicates the presence of AUD or SUD, the assessing therapist may recommend treatment at one of the following levels of care:

Outpatient Treatment

Outpatient treatment typically involves office visits of about an hour, once or twice weekly. Teens in outpatient treatment live at home, go to school, and continue to participate in most extracurricular and social activities.

Intensive Outpatient Programs (IOP)

These programs typically occur three to five days a week, two to three hours per day, in an office setting or at a specialized adolescent treatment center. Teens in IOP programs live at home and go to school. However, they may  or may not participate in extracurricular activities, depending on the severity of their disorder.

Partial Hospitalization Programs (PHP)

These programs typically occur five days a week for five to six hours per day at a specialized adolescent treatment center. Teens in PHP programs live at home, but do not go to school. In addition, most teens in PHP focus solely on recovery. They return to school, extracurricular and social activities upon completion of their treatment program.

Residential Treatment (RTC)

This is an immersive, intensive level of care. During residential treatment, teens live at an adolescent treatment facility with 24/7 support. Their days and evenings are free from distraction. This allows them to dedicate themselves one hundred percent to healing and recovery.

To learn more about levels of care in mental health and addiction treatment, click here.

This article will discuss a therapeutic approach to the treatment of alcohol and substance use disorder known as mindfulness based cognitive therapy (MBCBT). MBCBT is a common component of outpatient treatment, IOP treatment, PHP treatment, and residential treatment at a teen RTC.

We’ll offer definition of MBCBT, a brief overview of how it works, and describe the benefits teens in addiction treatment gain from MBCBT treatment.

Mindfulness Based Cognitive Therapy: A Definition

Mindfulness based cognitive therapy is exactly what the name implies. It’s a form of psychotherapy that combines cognitive behavioral therapy (CBT) with mindfulness techniques such as deep breathing and meditation.

To read more about CBT, click here.

Here’s a quick summary for those who don’t want to read that entire page.

CBT focuses on identifying and understanding the connection between thoughts, feelings, and behaviors. A CBT-trained therapist will work with a teen in addiction recovery to help them identify patterns of thought and emotion that lead to behaviors associated with addiction. Next, they teach them to then replace those life-interrupting patterns with the life-affirming patterns of thought and behavior associated with recovery. This process improves their overall well-being and increases their chances of sustained sobriety.

Mindfulness is a perfect companion to CBT. Mindfulness techniques pair particularly well with the initial steps of CBT, which involve identifying and understanding patterns of thought that have been operational for so long they’re automatic.

World-renowned mindfulness practitioner and advocate Thich Nhat Hanh defines mindfulness as “…our ability to be aware of what is going on both inside us and around us. It is the continuous awareness of our bodies, emotions, and thoughts.”

That’s what makes CBT and mindfulness a potent combination. They share a common goal: identifying what’s happening inside the mind and body in the moment. A teen in active addiction may not know they can identify – and learn to let go of – the patterns of thought that lead to addictive behavior. The trick to mindfulness in addiction treatment lies in allowing life-interrupting patterns of thought to rise and fade without judging them and without acting on them. A therapist trained in MBCBT teaches an adolescent in recovery to replace negative patterns of thought with life-affirming patterns of thought that support sobriety.

Benefits of Mindfulness-Based Cognitive Therapy

It takes practice, but research shows that mindfulness + CBT works. That’s why MBCT is a common therapeutic approach used in evidence-based treatment plans for alcohol and substance use disorder.

The benefits of MBCBT include:

Restructuring the Reward Circuit in the Brain

MBCBT helps reduce addictive behavior by teaching the brain to reestablish the value of natural rewards over the value of alcohol- or drug-related rewards.

Improved Cognition and Executive Function

MBCBT helps restore rational decision-making and impulse control, processes that become impaired with the long-term exposure to alcohol and substances of misuse. The ability to productively assess risk and reward – with a fully functioning executive control network – is an important part of maintaining abstinence and making choices that support recovery.

Improved Stress Tolerance

Physical and emotional stress can lead to patterns of thought and behavior that precipitate relapse. MBCBT can reduce stress reactivity and decrease time to stress recovery. That means it helps teens in treatment manage the magnitude and intensity of their responses to stressful stimuli and helps them return to a non-stressed state when stimuli do provoke a stress response. Both these outcomes decrease the likelihood of relapse

Reduced Cravings

Research shows that MBCBT can reduce both subjective cravings for drugs and alcohol and the physical symptoms of drug and alcohol craving. MBCBT helps teens in recovery separate the connections between depressed mood or heightened anxiety and the desire to seek and use drugs. Mental health professionals call this decoupling. When mood and drug seeking are decoupled with MBCBT, the likelihood of relapse decreases.

Improved Self-efficacy and Wellbeing

MBCBT strengthens fundamental levels of acceptance, non-judgment, and self-awareness that allow a teen in recovery to manage their psychological and emotional states. The mindfulness component helps them process the extremes of thought and emotions. The cognitive component helps them make productive behavioral choices. In combination, these components help teens in recovery find balance, which increases their sense of wellness and life satisfaction.

A key element of treatment and recovery is teaching – or restoring – skills that encourage self-reflection. This gives teens the ability to recognize the difference between healthy, life-affirming patterns of thought and the maladaptive patterns of thought associated with addiction. MBCBT, dialectical behavior therapy (DBT), and other forms of one-on-one therapy teach these essential skills.  But  they’re not the entire picture. The latest evidence shows that a holistic, integrated treatment program that addresses the whole person – not just the symptoms of addiction – is the most effective way to help people in recovery achieve sustained sobriety.

The Components of a High-Quality Teen Treatment Center

It’s important find a treatment center that offers customized, integrated treatment plans that address a teen’s unique biological, psychological, emotional, and social needs. Highly regarded treatment programs will include most of the following therapeutic modalities and techniques:

  • Individual therapy (as discussed in this article)
  • Group therapy
  • Family therapy
  • Community support
  • Experiential therapies
  • Prescription medication (if indicated)

The ideal addiction rehab center will work directly with parents and teens to create an individualized treatment plan. A good individualized plan works to the teen’s strengths. It leverages the insight they bring to the recovery experience. It addresses the whole person, not just the addiction.

The best way to find an appropriate treatment center is through a referral from a mental health professional. However, parents of teens who need treatment should spend time learning as much about any rehab or treatment center they consider. It’s important to:

  • Get online and look at their website.
  • Call and speak to treatment center staff.
  • Visit and see the place in person if possible.

Committing to treatment can be a life-changing choice. Parent of teens with an alcohol or substance use disorder can use these tips to ensure they find a program that gives their teenager the best possible chance at a successful recovery.

Finding Help: Resources

For parents seeking treatment for a teen with an addiction disorder, we recommend navigating  to our page How to Find the Best Treatment Programs for Teens and downloading our helpful handbook, A Parent’s Guide to Mental Health Treatment for Teens.

In addition, the American Academy of Child and Adolescent Psychiatry (AACAP) is an excellent resource for locating licensed and qualified psychiatrists, therapists, and counselors at any location in the country. Both the National Institute of Mental Health (NIMH) and the National Alliance on Mental Illness also provide and high-quality online resources, ready and waiting right now.

Our Behavioral Health Content Team

We are an expert team of behavioral health professionals who are united in our commitment to adolescent recovery and well-being.

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