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Alcoholism Treatment Programs and Interventions

Close to a million Americans are treated for alcoholism on a daily basis. For the past 3 decades, the majority of treatments have been empirical and the success of the treatments has never been verified by clinical trials. The numerous methods developed in the treatment of alcohol addiction include the use of medications, psychological, social, behavioural methods and self help groups- all designed to help achieve abstinenece from alcohol.

The initial approaches to alcohol treatment were all based on self help and over the years the 12-step self help program has become the gold standard. Other treatments include brief interventions by visiitng the primary care physician or trained nurses. Behavioral and psychosocial support therapies have evolved over years and generally involve long term therapy. Over the last 2 decades, motivational enhancement therapy and involvement of the non drinking spouse therapy have evolved and produced good results.
Of course, over the past 4 decades, pharmacological approaches to alcoholism treatment have made some progress, but the ideal drug is still remains to be discovered.

The majority of individuals with alcohol dependence initially always deny that they have a problem and are reluctant to undergo therapy. Agreeing to undergo alcohol treatment usually occurs after the individual encounters health, family, employment or legal problems. Depending on the situation of the individual, various treatments are available to help with alcohol dependence. The initial part of the treatment involves evaluation, a brief intervention and either an in/outpatient program or counseling.

Before alcohol treatment can begin, one has to determine if the individual is alcohol dependent. For some who drink socially and are in control over their drinking, treatment may simply require reduction of drinking. For those who have no control over their drinking the best treatment is abstinence.

To maintain abstinence, the best approach is to be included with alcohol abuse therapists. These specialists can help develop specific-tailor made treatment plans, which may include objectives, behavioral modification skills, use of self-help manuals, counseling and follow-up care at a treatment center.

There are numerous non-drug residential alcoholism treatment institutions and include therapy to maintain abstinence, individual and group therapy, participation in alcoholism support groups (such as Alcoholics Anonymous), educational seminars, spousal involvement, work assignments, physical and non physical activity therapy. Most of these residential programs have professional counselors and staff involved in the treatment of alcohol dependence.

All individuals undergo a complete physical and medical assessment prior to therapy. The essence of all residential programs is to commence detoxification and treatment of withdrawal symptoms that may occur. Hard-hitting psychological counseling and psychiatric treatment is offered to individuals, couples and their families. The principal emphasis of all residential programs is on recognition of the problem and motivation for abstinence. Individuals who are unable to fulfill this basic criteria usually do not succeed with therapy.

Numerous behavioural approaches to alcohol dependence treatment include psychological therapy. The primary component of these therapies is motivational enhancement therapy. This therapy is designed to help the individual beocme more responsible and develop a change in his life style.

Various forms of counseling are available and may involve cognitive behavior therapy to help cope with distorted/abnormal thoughts and help develop a sense of control over these thoughts and feelings.

The majority of pycholigcal therapies often involve the non alcoholic spouse as most studies show that couple participation increases the likelihood of abstinence from alcohol. Behavioural –marital therapy is a combination of an approach to drinking treatment while strenghtening the marital relationship through sharing, teaching and communication skills

The most common self help group in the treatment of alchohol dependence is Alcoholics Anonymous (AA). This is one of the most common and easily available group in any community.
Alcoholics usually get involved with AA before seeking professional help, as a part of it, or as aftercare following professional treatment. Although anecdotal data on the success of AA are plentiful, results indicate that inpatient treatment, a combination of professional treatment and AA, will achieve better results for more people than AA alone. The reason why AA has been beneficial as a treatment for alcohol addiction includes isolating the individual from his social network of alcoholic friends, providing psychological/social support, teaching coping skills and structured behaviour treatment.