Box 4: Types of psychotherapies and behavioural interventions

"Cognitive behavioural therapies

Cognitive behavioural therapies focus on:

  • (a) altering the cognitive processes that lead to maladaptive behaviours of substance users;
  • (b) intervening in the behavioural chain of events that lead to substance use;
  • (c) helping patients deal successfully with acute or chronic substance craving;
  • (d) promoting and reinforcing the development of social skills and behaviours compatible with remaining substance free.

The foundation of cognitive therapy is the belief that by identifying and subsequently modifying maladaptive thinking patterns, patients can reduce or eliminate negative feelings and behaviour (e.g. substance use).

Relapse prevention

An approach to treatment in which cognitive behavioural techniques are used in an attempt to help patients develop greater self-control in order to avoid relapse. Specific relapse prevention strategies include discussing ambivalence, identifying emotional and environmental triggers of craving and substance use, and developing and reviewing specific coping strategies to deal with internal or external stressors.

Contingency management

A behavioural treatment based on the use of predetermined positive or negative consequences to reward abstinence or to punish (and thus deter) substance-related behaviours. Rewards have included vouchers awarded for producing substance-free urine samples that can be exchanged for mutually agreed upon items (e.g. cinema tickets) and community reinforcement in which family members or peers reinforce behaviours that demonstrate or facilitate abstinence (e.g. participation in positive activities). Negative consequences for returning to substance use may include notification of courts, employers, or family members.

Motivational enhancement therapy

This brief treatment modality is characterized by an empathetic approach in which the therapist helps to motivate the patient by asking about the pros and cons of specific behaviours; by exploring the patient’s goals and associated ambivalence about reaching these goals; and by listening reflectively. Motivational enhancement therapy has demonstrated substantial efficacy in the treatment of substance dependence."

Source: WHO  Neuroscience of psychoactive substance use and dependence, Summary (2004),
Treatment and prevention: links with neuroscience, and ethical issues, Box.4, p.31

Related publication:
Psychoactive Drugs homePsychoactive Drugs Tobacco, Alcohol, and Illicit Substances
Other Figures & Tables on this publication:

Table 1. Prevalence of smoking among adults and youths in selected countries

Table 3. Percentage of total global mortality and DALYs attributable to tobacco, alcohol and illicit substances

Depressants – overview of effects

Table 5. Pharmacological treatments for substance dependence

Table 2. Annual prevalence estimates of global illicit substance use, 2000-2001Table 2. Annual prevalence estimates of global illicit substance use, 2000-2001

Figure 3. A terminal button and synapse

Figure 4. Two types of chemical synapses

Table 4. Summary of psychoactive substance effectsTable 4. Summary of psychoactive substance effects

Figure 5. Mesolimbic dopamine pathway

Box 3. Risk and protective factors for substance use

Figure 1. Adult (15+) Per Capita Alcohol Consumption by Development Status

Figure 2. Mechanisms relating psychoactive substance use to health and social problems

Box 4: Types of psychotherapies and behavioural interventions

Box 1: Injecting substance use and HIV/AIDS

Box 2: Criteria for substance use dependence in ICD-10