Which component is NOT a core CBT element for substance use disorders?

• A. Skills training
• B. Coping strategies
• C. Relapse prevention
• D. Exposure to cravings through scheduled relapse trials

Answer: (D)

CBT for substance use disorders centers on recognizing triggers, reframing thoughts, and using concrete skills to avoid use. The essential elements include skills training, which provides practical tools like problem-solving, assertive communication, and planning to handle high-risk situations; coping strategies, which are specific techniques to manage cravings and negative emotions in the moment; and relapse prevention, which involves identifying triggers, anticipating high-risk scenarios, and developing a plan to maintain abstinence and handle slips. Exposing someone to cravings through scheduled relapse trials is not a standard core component of CBT for SUD. While cue exposure or certain mindfulness-based approaches may address craving reactivity in some therapies, deliberately arranging relapse as part of CBT is not considered a universal or essential element and carries ethical and safety concerns.