Islamic Cognitive Behavior Therapy to Increase Self-efficacy, a Study on a Drug User Student

Abstract


Introduction
The problem of drug abuse is getting more complex day by day, the number of drug users is increasing.The National Narcotics Agency (BNN) issued data on the prevalence rate for a year of use in 2021, namely 1.95%, which shows an increase compared to 2019, which was 1.80%, or an increase of around 8.3% with contributions that varied for all age groups (BNN, 2021).This is a very alarming figure when viewed from the age of the majority of users.The National Narcotics Agency stated that the majority of victims of drug abuse are youths aged 15-24 years.These ages are of people in junior high school to university.These are individuals who belong to a productive age where they should be preparing for their future.
Law Number 35 of 2009 defines narcotics as substances or drugs that can cause dependence, decreased consciousness or loss of feeling.Narcotics are substances or drugs that are natural, synthetic or semi-synthetic in nature which cause a decrease in consciousness, hallucinations and excitability (HUMAS BNN, 2019).Narcotics Law article 1 paragraph 1 states that narcotics are artificial substances or those derived from plants that have a hallucinatory effect, decrease consciousness, and cause addiction.
The reasons for teenagers using drugs are curiosity or experimentation and seeking to have fun (Bachtiar, 2020).When individuals consume drugs, the brain is affected by the drugs.The brain will release a neurotransmitter which conveys the message "this substance is useful for the body's defense mechanism", and users might think they feel good.The user might think if I use drugs again, I will feel good again, and might think that my needs are being satisfied.Then the brain will record it as something to look for as a priority.As a result, the brain will create the wrong program, as if we really need it as a selfdefense mechanism, and then addiction will occur (BNN, 2009).Once the addiction sets in, they cover it up with rationalization and lies.They might think that they are able to control the emotions of those around them (Bachtiar, 2020).
Even though it is not visible to the naked eye, the problem of narcotics use has crossed the existing barriers in society.Regardless of gender, social strata, ethnic group, followers of religions, many experience the same serious problem.
Indonesia, a country with a majority Muslim population, with a large population, needs to solve this problem as soon as possible.
The problem of drug abuse is a complex problem.There are several factors that influence each other.There is an interaction of three interrelated factors (as we can see in figure 1., that can lead to drug abuse (BNN, 2009).

The Interaction of Three Factors Leading to Drug Abuse
Various ways to solve this problem are carried out by all concerned and interested parties, namely parents, counselors, psychologists, and others.
Behavioral researchers are also struggling in this matter from within and outside the country.Various ways to carry out therapy for drug users are also carried out so that the therapy is implemented effectively.
Based on the cognitive perspective on substance use, the beliefs and expectations held by individuals regarding drug effects greatly influence the individual's choice to use drugs or not (Nevid & Ratus, 2005).G.T. Wilson (in Nevid & Ratus, 2005) says that part of the attractiveness of drugs is their ability to increase expectations of self-efficacy (belief in our own ability to complete tasks), either directly or indirectly, directly by increasing feelings of energy,

INDIVIDUAL SOCIAL ENVIRONMENT
strength and happiness, while indirectly by reducing pressing conditions such as anxiety.An example is cocaine which can increase the perception of selfefficacy in an athlete who places great importance on achievement.Because of this, people are likely to rely on substances in challenging situations where they doubt their abilities.But what if the substance use is stopped, does someone still have the same belief that he can do his job or not?Self-efficacy is an individual's belief in carrying out the desired series of activities to get the desired results (Bandura, 2000).If an individual has low self-efficacy, then the individual will only do tasks that do not have challenges or have no obstacles.
If the obstacle is estimated to be too difficult, he will tend to back off and not carry out the activity.But if the individual has high self-efficacy, then he will go through the difficulties that are in front of him to reach the goals he wants to achieve (Bandura, 2000).
The psychoanalyst approach says that substance abuse is a sign of conflict that is rooted in childhood, so that if the underlying problem has been overcome, then the abusive behavior can be replaced with a more mature form to fulfill the satisfaction sought so that individuals can live their lives as before.
Although there are many reports that state the success of this method, the success of research that can be controlled and can be repeated is very few (Nevid & Ratus, 2005).Another psychological treatment is to use a cognitive and behavioral approach, with a therapy called Cognitive Behavior Therapy (CBT).By modifying behavior and changing cognitive processes, this approach emphasizes that users can learn to change their behavior and cognition when faced with temptation or when facing life's problems that they have to live through when they are off drugs (Nevid & Ratus, 2005).
Indonesia is a country with the largest Muslim majority population and is experiencing big problems with drugs.Therapists must reform their interventions to reflect Islamic values in order for the therapy to be more effective (Husain & Hodge, 2016).
Islamic cognitive behaviour therapy (ICBT) is a counselling assistance process in which Islamic values will be given to the counselee to change and improve the counselee's negative thoughts so they can change their behaviour (Ikhwan et al., 2019).ICBT studies are increasingly interesting to research and implement.Research on this is still scanty and much needed (Muhammad, 2023).ICBT is a form of cognitive-behavioral therapy integrated with Islamic values in which individual maladaptive beliefs, thoughts and emotions are changed by incorporating Islamic values.This ICBT repackages conventional CBT by integrating Islamic values that will be adhered to by patients and become part of the patients' daily life (Husain & Hodge, 2016).
Even in Western countries, therapists are increasingly likely to meet Muslim clients as Graham et al. observed in 2010.Here are some philosophical foundational differences between CBT and ICBT as shown in Table 1.

Individual rights
The self is separate and can be seen by others.Thus, personal interests and individual rights are prioritized.
Self cannot be separated from others.Collective rights and interests take precedence over individual interests.

Philosophical Foundational Differences between CBT and ICBT
In this study, the authors conducted an intervention on a research subject with the initials ISG who had been trapped in a cycle of heroin and alcohol use for 5 years.During these 5 years, ISG has experienced two relapses.Heroin hampered his education.He was expelled from the university he first chose.
Work was often neglected.Not only that, the effects of heroin use also affected the social life of his extended family.The price of heroin which is not cheap put his mother in debt everywhere just to get money to meet ISG's need to consume heroin.
This study studies the therapeutic process with the ICBT intervention that will be implemented.This research is expected to be of benefit to counselors and counselees, Islamic psychologists and their clients, and other interested parties.It is hoped that this research can become one of the guidelines for improving and maintaining the good quality of life of former drug users so that they do not fall back into the world of drugs again.
Although Islamic CBT shares similarities with conventional cognitive behavioral therapy CBT, there are differences.In Islamic cognitive behavioral therapy, the treatment approach or process is based on two main sources of Islamic teachings (Al-Qur'an and Hadith), according to Farihah and Rachman, 2017, in Munawar, et al., 2023.

Method
This study used a qualitative approach with single case experimental designs.Single case experimental designs are used in studies that want to see the effects of interventions by comparing the current conditions and conditions after the intervention is given to one or several individuals over a period of time (Kazdin, 2001).The research design used in this study is the A-B-A design.This is the easiest design to implement in the single case experimental design method.Phase A where the client's condition is without treatment and the conditions experienced by the client are analyzed and called the baseline phase.
Phase B is the condition where the treatment/intervention ICBT is given (intervention), and the last phase A is the condition where the researcher sees the effect of the intervention that has been carried out on the client or is called the follow-up phase.The research subject was one person who had been using drugs on a regular basis.In addition to believing he was feeling good, he also felt withdrawal if he did not use it regularly or stopped using drugs (Partodiharjo).This research was conducted at the Mental Health Care Rehabilitation Center located in East Bekasi, a rehabilitation institution in collaboration with the Cahaya Jiwa Education Foundation.
In this study, data collection was carried out using several methods, namely: interviews, observation, and the use of psychological tests.The interviews were conducted with general and specific themed questions.This interview guide is also used to guide as well as to ascertain whether aspects related to the theme have been discussed or asked about.With these guidelines, it is hoped that none of the required data will be missed.
Observation is directed by accurately paying attention to the phenomena that arises and recording them and also considering the relationship between aspects and these phenomena (Poerwandari, 1998).

Result and Discussion
ISG is a 23 year old male, unemployed and single.ISG has been stuck in a heroin trap for 5 years and has experienced relapses twice.Currently ISG is undergoing heroin addiction treatment at the Cahaya Jiwa Education Foundation using the Dadang Hawari detoxification method.Simultaneously ISG underwent psychological rehabilitation to improve his ability to get out of heroin addiction, as well as reduce anxiety and prepare himself for life's problems.Based on this, ISG was referred to undergo psychological examination and therapy.
The examination of ISG was first carried out on July 5, 2022 by a psychologist who was assisted by the foundation's counsellor, who is an ustadz, as we can see in -Providing education to the client about selfefficacy and its benefits with techniques of providing information and discussion.
-Apply it by giving assignments to the client to report his activities in full for 2 days (January 4 -5, 2023).The form is first determined by involving the client to discuss whether or not additional columns are added according to the client's needs.ISG is the 5th of 6 children.Currently, ISG lives in the same house with his parents and his second older sister, her husband and their children.Besides that, the house where ISG lives is next to or in the same location as the house of ISG's third older sister who has been divorced with her three children.
ISG's level of intelligence is above the average level according to his age level (113), but he has the potential for an IQ to be at the Superior level (122).This shows that ISG has not utilized all of his capabilities to the fullest so that there is still some potential that can be developed.
The examination also showed that ISG has a tendency to decrease in mental function by 13%, significantly indicating a tendency to decrease thinking skills.This is possible because of prolonged drug use.ISG's task performance score was higher than his verbal score, indicating that he has a better ability to work on concrete tasks than abstract symbols.ISG's thinking is dominated by the past.In terms of ability, he has a sharp enough observation, and he easily demonstrates his ability and but he has a tendency to be arrogant.In terms of desires and ambitions, ISG still has desires that have not been achieved.There is a desire to excel but there is a feeling of inadequacy that prevents himm from realizing his desires.
The case formulation in this study is 1) Cognitive Problems where there is a belief that he is unable to live life if he does not get a job, and cannot work if he is not given a job which in the end, can make him at risk of returning to using heroin because there are no resources funds as a life support and to pay off previous debts.2) Behavioural Problems.There are often complaints of not being able to survive in this life and reaching a dead end, and ISG struggles to find a job or create his own jobs, which further increases the risk of relapse.3) Problems Related to Emotions.Sad, annoyed, bored, anxious and feeling hopeless.4) Psychosocial problems.
He finds it difficult to interact with siblings because he is hated for his history as a heroin user, has an inharmonious relationship with his father, feels abandoned and not cared for anymore by the family so that he feels confused about his role and existence as a family member and this makes him confused in making his life decisions.

Multiaxial Diagnostics
The disturbance experienced by ISG is related to distortion of cognition about heroin.ISG has a difficult time accepting his father's necessary parenting style which makes him less able to communicate the problems he has and also makes him less able to feel the care of the family in his life.At the same time, his introduction to heroin gave him perceived pleasure, disregarding that this is haram in Islam.The effect that is felt is perceived comfort and a false sense of self-confidence arises.The distortion of thought experienced is that the discomfort in dealing with problems can be exchanged for false comfort when consuming heroin.In the end, this behavior occurs repeatedly and whenever there is a problem, then he thinks the best solution is to use heroin.This also makes for a negative learning process which results in low self-efficacy.ISG feels that he wants to move on with life and pay off his debts, but until now he has not found a job and have made no attempt to get a job other than waiting for it to be given by someone else.This eventually led to new problems, namely the accumulation of debts and the ever-increasing living needs.
The psychological examination showed that ISG's intellectual capacity functions at a level above the average/high average (113) based on the Weschler scale, while his intellectual potential is at a superior level (122).This shows that ISG has an easy ability to receive and process new and complex information.Apart from that, his ability to make graphic designs can also be used as an asset for him to find work and to support himself financially.The implementation of ICBT made ISG aware of life's importance and improves his life's quality.

Conclusion
Based on the results of the study, it can be concluded that the clinical picture of Opiate addiction (34.00,Table 3) before receiving the intervention showed the following symptoms: difficulty concentrating, feeling false sense of euphoria, feeling a false sense of confidence, feeling worthless, emotionally unstable, having illogical thoughts, and having feelings of excessive anxiety.
The results of applying Islamic Cognitive Behavioral Therapy by identifying ISG's negative thoughts and recording and discussing negative thoughts together in a predetermined form reduced his negative thinking and helped him prioritize quality life.The implementation of ICBT makes ISG aware of life's importance and improves his life away from drug addiction..
, fromBeshai, Clark, & Dobson, 2013: Psychological tests are a method for taking examples of someone's behavior in standard situations(Sundberg, 2007).In other words, psychological tests are a standard and objective method for obtaining examples of behavior (Anastasia and Urbina in Sunberg 2007).Psychological tests are used as the main tool to better understand the client's situation in addition to observation and interviews(Suprapti, 2003).In this study, the researchers used several test tools, namely 1) Graphic tests included in the class of projection tests and image tests that would reveal things that the client was lacking or not aware of, including the client's defense(Suprapti, 2003).In the DAM test, the client is asked to draw people on a blank sheet of paper.In the BAUM test, the client is asked to draw a tree.In the HTP test, the client is asked to draw houses, trees and people on one width of blank paper.2) The WB test is an intelligence test.This test aims to reveal individual intellectual functions specifically intended for adults.In this test, the client is given a number of questions related to general knowledge, a person's ability to behave and his ability to explain a word based on his understanding.Clients are also asked to count and arrange several shapes into a meaningful picture.3) The MMPI test belongs to a standardized inventory class that aims to reveal a person's personality at all levels of emotional adjustment and attitude of the person being tested.In this test, the client is asked to choose one of the two statements provided which are considered appropriate to the person's condition.This test was developed by Hathaway and McKenley in 1940.4) The SSCT test is in the form of a projection test or personality test.The function of this test is to reveal what the client feels and thinks about himself, his family environment, school environment, work environment, and friendship relationships.In this test, the client is asked to write down his thoughts regarding the questions listed on the question sheet.In this study, the type of therapy given to clients was Islamic cognitive behavioral therapy/ICBT.Therapeutic techniques are given according to the needs and conditions experienced by clients including: Self-Education, Cognitive Restructuring, and Self-Report.In implementing cognitive behavioral therapy on clients, evaluations that can be carried out to measure the increase in client self-efficacy are a) Physical form of the client's planned business activity proposal, b) Client descriptive reports, c) Client family descriptive reports, d) Institutional descriptive reports, and e) Pre-test and posttest rating scale.
counselor about the condition of the ISG who chooses to stay at home.The reason that ISG is confused is the difference

:
The aunt that takes care of mother and sister : Father has been sick from a stroke : The eldest brother who plays the most important role in The initial motivation for getting therapy greatly influenced ISG's level of discipline towards the therapy process that was undertaken.At this motivational intervention stage, basic Islamic values were included which should motivate individuals to behave with the blessing of Allah SWT.A person's motivation to stop using heroin is a form of worship and obedience to the commands of Allah SWT.Motivation based on Islamic values makes the therapy process faster and more effective(Hodge, 2011)

Table 2
. The examination was carried out by carrying out anamnesis with ISG and allo anamnesis with ISG's family.Several counselors handled ISG, observation, supported by several implementations of psychological tests.