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In addition to medications, alcoholism treatment programs use counseling and group therapy to help you stop drinking. Most alcoholics need help to recover from their disease. With support and treatment, many people are able to stop drinking and rebuild their lives.

Self-Help Groups
Alcoholics Anonymous

Self-help groups are the most commonly sought source of help for alcohol-related problems. Alcoholics Anonymous (AA) is one of the most well known self-help groups. AA emphasizes person-to-person, group relationships, and commitment to recovery. Meetings consist mainly of discussions about the participants’ problems with alcohol and testimonials from those who have recovered. AA outlines 12 consecutive activities, or steps, that you should achieve during the recovery process. You can become involved with AA before entering professional treatment, as a part of it, or as aftercare following professional treatment.

Psychotherapy
Cognitive Behavioral Therapy

A number of cognitive and behavioral therapies may be used in the treatment of alcohol abuse and alcoholism. These approaches target thoughts and behaviors that may contribute to the abuse of alcohol. Cognitive behavioral interventions have been shown to improve mood and reduce substance abuse.

Aversive conditioning is a behavioral approach in which the consumption of alcohol is associated with a wide range of noxious stimuli. Another approach, self-control training, can help you reduce your intake of alcohol without totally abstaining. A variety of coping skills and stress management techniques may also be used.

A style of behavioral therapy called "contingency management" involves rewarding desirable behavior (not drinking) with privileges or material rewards.

Relapse prevention will help you recognize early warning signs of relapse. You will identify high-risk situations, such as parties and sporting events, and learn to assess your own vulnerability to relapse. You will learn coping skills to help you avoid or remove yourself from risky situations. You are also taught how to handle a relapse so that you don’t become discouraged and lose confidence.

Psychosocial Therapy
Motivational Enhancement Therapy

Motivational enhancement therapy (MET) is based on the assumption that you have the responsibility and capacity for change. Your therapist begins by providing you with individualized feedback about the effects of your drinking. Working closely together, you and your therapist will explore the benefits of abstinence, review treatment options, and design a plan to implement treatment goals.

Couples Therapy

It is often very helpful to involve a nonalcoholic spouse or significant other in your treatment program. This can increase the likelihood that you will complete therapy and continue to abstain after treatment ends.

Behavioral-marital therapy (BMT) combines a focus on drinking with efforts to strengthen your marital relationship. BMT involves shared activities and the teaching of communication and conflict evaluation skills. Couples therapy may also be combined with the learning and rehearsal of a relapse prevention plan. Among alcoholics with severe marital and drinking problems, the combination approach produces improved marital relations and higher abstinence rates.

Brief Interventions

Brief interventions involve counseling from primary care doctors or nursing staff during five or fewer standard office visits. In brief interventions, you will receive information on the negative consequences of alcohol abuse. You will also learn about strategies and community resources to help you achieve moderation or abstinence.

Most brief interventions are designed to help you if you are abusing alcohol and are at risk for developing alcoholism. They are designed to help you reduce your alcohol consumption. If you are alcohol-dependent, however, you are encouraged to enter specialized treatment with the goal of complete abstinence.

References:

Alcoholics Anonymous. Available at: http://www.alcoholics-anonymous.org/en_information_aa.cfm. Accessed April 15, 2007.

Carson RC, Butcher JN, Mineka S. Abnormal Psychology and Modern Life. 11th ed. Boston, MA: Allyn and Bacon; 2000.

Huebner R. Advances in Alcoholism Treatment. Alcohol Research & Health. 2011;33:295-299.

Kleber HD, Weiss RD, et al. Practice Guideline for the Treatment of Patients with Substance Use Disorders. 2nd ed. American Psychiatric Association website. Available at: http://www.psychiatry.org/practice/clinical-practice-guidelines. Accessed April 14, 200.

Marlatt GA, Donovan DM, eds. Relapse Prevention. 2nd ed. New York, NY: The Guilford Press; 2005.

National Institute on Alcohol Abuse and Alcoholism website. Available at: http://www.niaaa.nih.gov.

Rubak S. Motivational interviewing: a systematic review and meta-analysis. Br J Gen Pract. 2005;55:305-312.

Stern, TA et al. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia: Mosby Elsevier, 2008.



Last reviewed February 2014 by Peter J. Lucas, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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