Most of the psychological treatments indicated for alcoholism are based on the cognitive-behavioral model, which assumes that this substance is a powerful reinforcer capable of maintaining self-administration of alcohol.
Thus, the cognitive behavioral model offers an alternative to the classic approach of alcoholism as a disease and, therefore, to the medical model.
- The ultimate goal of the psychological treatments indicated for alcoholism is to decrease the person’s preference for alcohol.
- Therefore.
- They increase their preference for other activities that allow them to maintain long-term adaptive functioning.
Another objective could be, depending on the patient, their personal resources and the family or social environment, to train for the non-problematic use of the substance. This has been called “controlled consumption”.
Currently, in psychological treatments of alcoholism we can differentiate two large blocks of intervention, those that point to abstinence and those that point to non-hazardous consumption, in a controlled way, we will describe them below.
The behavioral model aims to change behaviors directly related to alcohol consumption, thus the responsibility for their problem is assigned to the individual and, therefore, also the responsibility for their change.
Among the psychological treatments indicated for alcoholism that aim to prevent the patient from drinking, the scientific journal states:
It is used in patients who do not have the right interpersonal and intrapersonal skills or who cannot control their emotional state if it is not through alcohol.
It has been observed that addicts consume less alcohol if, in a stressful social situation, they have an alternative coping strategy.
An example could be The Monti et al Manual. (2002). It proposes social strategies for the patient and their support network, without resorting to consumption.
The patient is asked to change their substance use lifestyle, and techniques such as problem solving, family behavioral therapy, social counseling and job search training are included.
It can also be used for a controlled consumption strategy
It is to ensure that alcohol consumption is no longer a booster for withdrawal to be the goal.
To do this, it is necessary to carry out pleasant activities, especially those that do not involve drinking, with the couple.
An example could be the Sisson and Azrin program, which aims to teach non-alcoholic members ways to reduce physical violence, encourage sobriety, and seek treatment.
The goal is to reduce or eliminate the individual’s desire for alcohol, different stimuli or images are used to obtain a negative conditioned response for signs related to the drink (color, smell?).
Various aversive stimuli have been used, from the classic electric shock with Kantorovich in 1929 to chemical or imagination aversion.
An example of such treatment could be the “covert consciousness” proposed by Cautela in 1970. Generally, 8 sessions are sufficient to achieve results.
The best known is Marlatt and Gordon. The customer faces the challenge of taking responsibility for their change in behavior and, therefore, the continuation of the objective change, once obtained.
In addition, relapse prevention should take into account the increase in your coping strategies in high-risk stress situations.
They are used when the person does not want to abstain completely or does not have physical problems. The most representative program of this group of psychological treatments for alcoholism is Sobell
The Sobell program
Therefore, it is part of a self-management approach, since the objective is to carry out a brief intervention, in which the individual puts into practice many of the strategies taught.
These drinkers are generally young, well-educated, employed, with few severe episodes of alcohol withdrawal syndrome, with a history of abuse of five to ten years, plus they have personal social and financial resources, do not look different from others and are able to make significant changes in their lives.
The Sobell program
Its recommendations include not consuming more than 3 units of drink a day and not drinking more than 4 days a week, in order to reduce the level of alcohol tolerance.
In addition, other points are not to drink in high-risk situations, not to drink more than one unit of drink per hour and to delay 20 minutes the time between the decision to drink and drink.
It is a program in which training in problem solving and relapse prevention is of great importance, in this way the person outlines the situations related to consumption in his life and develops strategies to address them.
For complete abstinence and controlled consumption, the ultimate goal is for the patient to learn alternative strategies that limit their cravings for alcohol.
This can be achieved by acquiring social skills to say no to people who encourage us to drink, or by effectively solving the problems that alcohol used to face.
The goal is to get rid of addiction and start a path where, even if we feel an inherent discomfort, we can focus and more effectively address the problems that arise.
In this sense, the controlled consumption programme is now of great importance, due to the increase of young people facing their problems and emotions by drinking excessively on weekends.
It is essential to ensure that these young people do not become pathological drinkers and learn effective ways to manage their lives that do not involve drug use.