How CBT Helps Rebuild Self-Esteem in Methamphetamine Recovery

Adam, A., Hanafi, A., Nurfaizah, S., & Alim, A. (2023). Experimentation test of cognitive behavioral therapy techniques on recovery motivation for drug addicts. East African Scholars Journal of Psychology and Behavioural Sciences, 5(4), 77–88. https://doi.org/10.36349/easjpbs.2023.v05i04.002

Summary by: Naya Twal

Self-esteem can be one of the psychological resources affected by addiction and an important part of the recovery process. For individuals struggling with methamphetamine use, feelings of shame, guilt, and diminished self-worth may create additional challenges during rehabilitation. A study conducted at LRKM Mitra Husada in South Sulawesi, Indonesia, offers promising insights into how Cognitive Behavioral Therapy (CBT) may help improve self-esteem among people undergoing treatment for methamphetamine use.

Methamphetamine use remains a serious public health concern, both in Indonesia and worldwide. Beyond its physical and behavioral consequences, problematic substance use can also affect emotional well-being, confidence, and perceptions of personal worth. Against this backdrop, interventions that target not only substance-related behaviors but also cognitive and emotional functioning are particularly valuable.

Adam et al. (2023) explored whether a structured, five-session CBT counseling program could improve self-esteem among methamphetamine users enrolled in outpatient rehabilitation. The study involved 36 participants in a quasi-experimental design, divided into two groups of 18. One group received CBT, while the control group received educational brochures. Self-esteem was assessed before and after the intervention using the Rosenberg Self-Esteem Scale (RSES), with participants classified into low, moderate, and high self-esteem categories.

The results were promising. Participants who received CBT showed a statistically significant improvement in self-esteem (p < .001). The average coded self-esteem category increased from 1.61 to 2.67 on a three-level scale. Even more encouraging was the shift in self-esteem categories: the proportion of individuals with low self-esteem dropped from 44.4% to zero, while those classified as having high self-esteem increased from 5.6% to 66.7%. Meanwhile, the control group showed no statistically significant change (p = .257). The researchers also reported a significant difference between the groups at post-test (p = .003).

Why might CBT make such a difference? CBT helps individuals identify and challenge negative thought patterns that may reinforce shame, hopelessness, and self-blame. For people who enter treatment struggling with guilt or a sense of personal failure, learning to develop more balanced and constructive self-beliefs may support psychological recovery. The intervention used in this study included identifying cognitive distortions, recognizing triggers and cravings, planning daily activities, practicing positive self-talk, and developing relapse-prevention and substance-refusal skills. Together, these techniques aimed to strengthen both self-esteem and practical coping abilities.

Of course, the study is not without limitations. Its small sample size, quasi-experimental design, and reliance on a single rehabilitation center mean that the findings should be interpreted cautiously. The assessment was limited to short-term changes in self-esteem, and the study did not establish whether these improvements were sustained over time. Additionally, substance use outcomes and relapse rates were not directly measured, making it difficult to determine whether increased self-esteem translated into long-term recovery success.

Nevertheless, the findings point to a promising direction: integrating CBT into addiction rehabilitation programs may help strengthen psychological resources that are important for recovery. Further controlled studies with larger samples and longer follow-up periods are needed to determine whether these benefits persist and contribute to broader treatment outcomes.

Ultimately, strengthening self-esteem is more than a superficial goal. Feeling capable of change and developing a more positive sense of self may support motivation, resilience, and the ability to cope with setbacks. Although this study cannot establish lasting recovery benefits, it suggests that CBT may help individuals begin rebuilding their sense of self-worth as part of the rehabilitation process.