Abstract
Cognitive therapy has lately gained a more central role in Finnish treatment of different problem behaviors. Abroad, research has shown the model to be effective in the treatment of, e.g., depression, panic disorder, eating disorders, OCD, and borderline personality disorder. From the early '80s onwards, the model has also been applied in the treatment of substance abuse.
Cognitive therapy is more goal-oriented than psychodynamic therapy and is also more structured and task-oriented. Beside the purely cognitive tools, like Socratic dialogue, the therapy also includes a variety of techniques from the behavior therapy tradition. Today the therapy model is in a period of rapid change and can be seen as stressing more complex conceptualizations of the human mind and problem behaviors.
The case presented in the article is a 29-year-old female with a 5-year stretch of marijuana and cocaine abuse. The patient sought treatment because of depressive episodes and problems resulting from her drug use. In the treatment process described, the therapist and the patient together analyzed and modified her dysfunctional addictive beliefs and tried to elaborate the personal meaning of her drug use. It was hypothesized that this web of meanings (and the resulting addictive beliefs) had been the key factor in the development and maintenance of the problem behavior. This was also found to be the case as through the use of Socratic dialogue the therapist guided the patient to construct new meanings and targets for her view of herself and her behavior.