Cognitive Restructuring Based on Metaphor Therapy to Challenge the Irrational Beliefs of Drug Addicts Undergoing Buprenorphine Treatment

Abstract

Background: The use of metaphors rather than direct suggestions of treatment can help to weaken defense mechanisms against any functional changes and so cause an increase in the effectiveness of therapeutic interventions. Objectives: This research was conducted with the aim of determining the effectiveness of individual metaphor therapy (IMT) in reducing the irrational beliefs and cognitive restructuring of drug addicts undergoing buprenorphine treatment. Patients and Methods: Using a randomized controlled trial (RCT), 100 drug addicts who were referred to MMT/BMT centers in the city of Kermanshah, Iran, from July to September 2014 were selected through single-stage cluster sampling. After excluding 56 patients from the study due to their failure to meet the inclusion criteria, 44 people (37 at the end) were randomly enrolled into the experimental (n = 19) or control groups (n = 18). The SCID-I and the Jones' Irrational Beliefs tests were used as a means of measurement. Ten sessions of IMT (one session per week) were used as the intervention for the experimental group. The controls received routine cognitive restructuring. Data analysis was conducted using a multivariate analysis of covariance (MANCOVA). Results: After adjusting for age and gender, the findings of the study revealed that IMT was significantly effective in reducing the irrational beliefs of approval seeking (P = 0.02), high self-expectation (P = 0.01), frustration reactivity (P = 0.03), anxious over concern (P = 0.02), and perfectionism (P = 0.006). Conclusions: Since IMT can repeatedly neutralize patients' defenses without aggravating their anxiety, and as the therapy can help patients via the development of a new awareness or reformatting the patients' condition, it is recommended that this kind of therapy be used more widely in cognitive restructuring among drug addicts.

Hippocampus and amygdala: An insight-related network involved in metaphorical solution to mental distress problem

“…intentional use of metaphor as more helpful than other sessions (Martin, Cummings, & Hallberg, 1992). Additionally, empirical evidence has demonstrated that metaphor is effective in ameliorating irrational beliefs (Komasi, Saeidi, Zakiei, Amiri, & Soltani, 2016), as well as in changing catastrophizing and pain biology knowledge (Gallagher, Mcauley, & Moseley, 2013).…”

“…We further sought to identify the specific brain regions activated by therapeutic metaphor, because empirical evidence has demonstrated that therapeutic metaphor is more effective in alleviating mental distress (Gallagher et al, 2013;Komasi et al, 2016), and the insightfulness experiences produced by therapeutic metaphor in the micro-counseling scenarios could predict the reduction of negative affect after the intervention (Hu et al, 2018). The neuroimaging studies demonstrated that metaphor comprehension induced different activities than did literal sentences; metaphor significantly increased signal changes in the left inferior frontal gyrus (IFG; Brodmann area (BA) 45/47), as well as in the left inferior and middle temporal gyri (ITG and MTG, respectively) (Rapp et al, 2004;Bohrn et al, 2012;Rapp et al, 2012).…”

Mobile Intervention: A New Proposal for Increased Success of Methadone/Buprenorphine Maintenance Treatment in Iranian Population

“…The center's treatment protocol is multi-component. Except for medication delivery, the protocol simultaneously involves psychological interventions and social worker services (2,3). According to available reports, these centers have been able to control drug abuse.…”

Perceived Behavioral Etiology of Cardiovascular Diseases Is Able to Predict a Health-Promoting Lifestyle in Men Under Methadone Therapy in Kermanshah City, 2017

“…Drug addiction, defined as a chronic, progressive, and destructive illness, is common throughout the world (1). although there is plenty of studies on heart risk factors among smokers (2), there is a shortage of studies on cardiovascular diseases (CVDs) risk factors among drug addicts (3).…”