It is based on the methods and principles of motivational interviewing (Miller et al., 1992). It is patient centred and aims to result in rapid internally-motivated changes by exploring and resolving ambivalence towards behaviour. The treatment strategy of motivational interviewing is not to guide the client through recovery step-by-step, but to use motivational methods and strategies to utilise the patient’s resources. A more specific manualised and structured form of motivational interviewing based on the work of Project MATCH is usually utilised (Project MATCH Research Group, 1993). This section draws on a more extensive review of the area by Roth and Pilling (2011), which focused on CBT because this area had the most extensive research.
How doctors diagnose alcohol dependence
One study evaluated the efficacy of an integrated 20-week programme of CBT with case management in a population of substance-misusing young people (aged between 15 and 25 years). Treatment resulted in a significant improvement in abstinence rates as well as a reduction in the number or participants meeting diagnostic thresholds for dependence. This study (like others) evaluates the effectiveness of psychological interventions for young people including participants whom are over the age of 18 years. However, this age-range makes interpretation of datasets such as this difficult. Six RCT trials relating to clinical evidence met the eligibility criteria set by the GDG, providing data on 527 participants.
Standard cognitive behavioural therapy
A CBT adaptation based on the work of Marlatt and Gordon (1985), this incorporates a range of cognitive and behavioural therapeutic techniques to identify high-risk situations, alter expectancies and increase self-efficacy. Other types of drugs are available to help manage the symptoms of withdrawal that may occur after someone with alcohol dependence stops drinking. Early recognition of these symptoms and immediate treatment can prevent some of them or drastically limit their severity. For some people, alcohol dependence can also cause social problems such as homelessness, joblessness, divorce, and domestic abuse.
11.2. Clinical review protocol (contingency management)
- WALITZER2009 assessed a directive approach to TSF versus a motivational approach to TSF in addition to treatment-as-usual (coping skills).
- The sooner treatment starts, the less likely there will be lasting negative effects — and the more likely the rehab program will have positive results.
- In conclusion, this article has comprehensively explored the psychology of alcohol dependence, covering diverse aspects from its definition and historical evolution to its prevalence, impact, etiological factors, diagnosis, and treatment approaches.
- An evidence summary of the results of the meta-analyses can be seen in Table 70.
However, no significant differences were observed between contingency management https://ecosoberhouse.com/ with network support and control for follow-up periods greater than 15 months. Of the three included trials, two trials evaluating contingency management versus treatment as usual (standard care) met criteria for inclusion. Both ALESSI2007 and PETRY2000 assessed contingency management with standard care versus standard care alone. Treatment providers are now required to consider not only treatment efficacy but also cost effectiveness, and for this reason treatment matching has remained an appealing option (Moyer et al., 2000).
Nicotine in Psychology: Exploring Its Definition, Effects, and Implications
FALSSTEWART2006 investigated a psychoeducational intervention (as an attentional control) versus BCT (plus individually-based TSF) as well as individually-based TSF alone. SOBELL2002 investigated psychoeducational (bibliotherapy/drinking guidelines) versus motivational enhancement/personalised feedback. The review team conducted a systematic review of RCTs that assessed the beneficial or detrimental effects of social network and environment-based therapies in the treatment of alcohol dependence or harmful alcohol use. The issue is further complicated by the fact that many of the trials that evaluate the efficacy of these interventions, and that are representative of this population, involved participants with comorbid drug misuse. This section aims to review the evidence for psychological interventions for the treatment of alcohol dependence and harmful alcohol use in children and young people. In addition, the patient populations assessed in these trials more often than not have comorbid substance misuse.
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- Or, maybe you prefer energy drinks, but only when you have a big day coming up.
- The single trial included in this analyses involved a comparison of guided self-help-based treatment versus non-guided self-help-based treatment.
- Three trials relating to clinical evidence met the eligibility criteria set by the GDG, providing data on 1,058 participants.
Because gamma-aminobutyric acid (GABA) has a quieting effect on the brain, gamma-aminobutyric acid (GABA) agonists also psychological dependence on alcohol have a quieting effect; these types of drugs are often prescribed to treat both anxiety and insomnia. Psychological dependence just refers to the way that some people come to emotionally or mentally rely on a substance. If you feel you’re drinking more than you’d like or your alcohol use is making your depression symptoms worse, there are some things you can do.
- Simultaneously, the brain’s attempts to compensate for alcohol’s sedative effects on the GABA system can make it hypersensitive to stress during withdrawal, further increasing depressive symptoms.
- One of the main challenges in providing services for alcohol treatment is to increase the effectiveness of the interventions offered.
- Understanding this historical context is pivotal for appreciating the evolving nature of societal attitudes towards alcohol use.
- Although they may not fully commit, they weigh the costs and benefits of making a shift.
Moreover, the study highlighted increased cancer risks at all alcohol levels, suggesting alternatives like exercise or meditation. A doctor may diagnose alcohol dependence if you show two or more of the above symptoms based on the ongoing pattern of how you use alcohol. Usually this is based on behaviour what is alcoholism over the last 12 months or more, but alcohol dependence could be diagnosed based on continuous daily (or almost daily) use of alcohol over a period of at least three months. As dependence gets more established, you might find you end up spending most of your time thinking about alcohol or engaging in activities necessary to obtain, consume, or recover from the effects of drinking. During Bigg Boss OTT Season 2, Bhatt opened up about her journey of overcoming alcoholism at the age of 44.
10. BEHAVIOURAL THERAPIES (EXCLUDING CONTINGENCY MANAGEMENT)36
- The major limitations of this analysis were the lack of descriptive detail on the resource use and costs considered whilst no incremental analysis was presented.
- It’s true that psychological dependence and physical dependence are different concepts, but there are also some ways in which the two are connected and may lead to alcohol use disorder.
- For maintaining abstinence, an individual assessment treatment programme was significantly more effective than a packaged CBT program when assessed post-treatment (moderate effect size, based on a single study).
- The Grove Editorial Team is committed to educating, supporting, and empowering individuals and families on their journey toward a healthier, substance-free life.
By acknowledging the complex interrelationships between alcohol dependence and co-occurring disorders, clinicians can tailor interventions to address the interconnected challenges, fostering improved treatment outcomes and sustained recovery. Frequently, alcohol misuse does not occur in isolation but alongside other mental health disorders, a situation known as co-occurring disorders or dual diagnosis. Common co-occurring conditions include depression, anxiety, bipolar disorder, and PTSD. Treatment for alcohol dependence in such cases must address both the addiction and the mental health condition to ensure a holistic recovery. This dual approach helps prevent relapse and promotes a more stable, long-term recovery. Both included trials assessed multi-modal treatment versus another active intervention.
Nevertheless, the GDG’s view was that, given the considerable problems that young people face, abstinence remained the preferred goal. The UKATT study (2005) evaluated the cost effectiveness of MET versus SBNT amongst a population comprising people who would normally seek treatment for alcohol misuse at UK treatment sites. The outcome measure used in the economic analysis was the QALY, which was estimated by using the EQ-5D questionnaire completed by patients at baseline, 3 and 12 months. The primary measures of clinical effectiveness were changes in alcohol consumption, alcohol dependence and alcohol-related problems over the 12-month period. The authors made no formal attempt to compare the total costs of a psychological intervention in addition to home detoxification with home detoxification alone.
Cognitive behavioural therapies versus treatment as usual or control
Prolonged alcohol misuse affects nearly every system in the body, from the brain to the liver. The earlier intervention occurs, the less chance there is for these harmful effects to accumulate. Stressful events, such as bereavement or losing a job, can also trigger heavy drinking in some people, which can then lead to alcohol dependence. If you think you may be dependent on alcohol, you should consult your doctor or another medical professional before stopping drinking. You could speak to a health professional at your GP surgery, or there are also a number of national alcohol support services that you can confidentially self-refer to for advice and support. Being dependent on alcohol has a range of harmful physical and psychological effects.