Alcohol Treatment : What really works?

Alcohol treatment comes in many forms. An exhaustive review by Miller and Hester (1986) of the literature on alcohol treatment examined nine major classes of interventions. They found the four most common being drug treatment, psychotherapy or counseling, Alcoholics Anonymous, and alcoholism education. Some the less commonly used approaches included family therapy, aversion therapies, behavior modification methods, controlled drinking and various other approaches spreading across a broad-spectrum of therapeutic approaches. Alcohol treatment is best approached according to Beck, Wright, Newman and Liese, (1993) as a two-stage process which require different interventions at each specific stage. The first set of interventions include promoting changes in drinking behavior toward abstinence or moderation, which frequently utilize some type of behavioral self-control training. The second set of interventions of an alcohol treatment program should be more focused on maintenance of the sobriety, which may involve additional interventions such as social skills training, in order to increase an individuals confidence in relating to drug-free individuals.

Alcohol Treatment Recommendations: Institute of Medicine

The Institute of Medicine commissioned an exhaustive critical review of the research literature related to alcohol treatment. Its conclusions were published in Broadening the Base of Treatment for Alcohol Problems (1990 a) which included the following recommendations:

1. There is no single alcohol treatment approach that is effective for all persons with alcohol problems.
2. The provision of appropriate, specific treatment modalities can substantially improved outcome.
3. Brief interventions can be quite effective compared with no treatment, and they can be quite      cost-effective compared with more intensive alcohol treatment.
4. Treatment of other life problems related to drinking can improve outcome in persons with alcohol problems.
5. Therapist characteristics are partial determinants of outcome.
6. Outcomes are determined in part by alcohol treatment process factors, post-treatment adjustment factors, the characteristics of individuals seeking treatment, the characteristics of the problems, and the interactions among these factors.
7. People who are treated for alcohol problems achieve a continuum of outcomes with respect to drinking behavior and alcohol problems and follow different courses of outcome.
8. Those who significantly reduce their level of alcohol consumption or become totally abstinent usually enjoy improvement in other life areas, particularly as the period of reduced consumption becomes more extended (pp.147-148).

Alcohol Treatment: Final Comments

These alcohol treatment recommendations by the Institute of Medicine (1990a) in conjunction with those of Miller and Hester (1986) make it apparent that there is still a tremendous need for effective treatments. An evaluation of alcohol treatment programs should be based upon an understanding of whether these particular aspects have been integrated into the treatment program.

Additional Information and webpage by Paul Susic  MA Licensed Psychologist   Ph.D. Candidate  (Health and Geriatric Psychologist)

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