There are several therapies used in the treatment of alcohol addiction and relapse prevention. The list below offers a brief summary of some of the most recommended methods, and further information on many of them is available in some of the other posts and slides posted on the blog. Keep in mind that the client's age, gender, ethnicity, religious background, and other characteristics will impact the treatment that is used. Resources for some of these particular populations are linked in the Additional Resources section.
Relapse Prevention Therapy (RPT)
RPT is a cognitive-behavioral approach to treating addiction and specifically relapse. RPT intervention strategies include coping skills training, thought management, and lifestyle modification. Much of the information presented on this blog incorporates RPT and cognitive-behavioral methods of treating alcohol addiction. For a thorough guideline on incorporating RPT please see this resource: http://www.bhrm.org/guidelines/RPT%20guideline.pdf
Motivational Interviewing
The clients themselves give reasons why they should be abstinent and draw up a list of problems caused by their alcoholism. See the blog post below for more information on this form of therapy.
Twelve-Step Facilitation
Programs where clients either individually (such as in project MATCH) or in a group setting (like Alcoholics Anonymous) progress through a series of steps involving self-discovery, healing/coping skills, and support mechanisms in order to complete their recovery. This form of treatment is often used as a primary or supplementary form of therapy.
Community reinforcement approach
A friend or family member participates in the recovery of the addict by providing positive reinforcers to reward abstinence and negative reinforcers to punish drinking. Radio, television, newspapers, telephone or driving licence are examples of reinforcers. The spouse or friend may also help reinforce other aspects of treatment such as relapse prevention group attendance, counseling sessions, and the addict's use of disulfiram prescription. You can find more information here: http://pubs.niaaa.nih.gov/publications/arh23-2/116-121.pdf
Social behavior and network therapy
Alcoholics build support networks using cognitive-behavioral and community reinforcement approach principles.
Contingency management
"Contingency management is designed to reinforce small steps, especially at the beginning, like celebrating each attendance at a group meeting or each drug-free test result. Later, patients can move on to larger achievements like stable housing. Easy-to-earn material goods, such as movie passes and food vouchers, help to both initiate and maintain positive changes." (Rockefeller University, 2005). According to Luty (2006), contingency management (or planning) is generally considered an addition to therapy rather than a substitute, and the fact that some reinforcements may 'pay' alcoholics not to drink makes this form of treatment controversial. "Furthermore, there is a tendency to relapse when the reinforcing regime is ended. This may explain the reluctance of many services to introduce contingency managemen"t (Luty, 2006). Further information can be found here: http://pubs.niaaa.nih.gov/publications/arh23-2/122-127.pdf
Cue exposure
Cue exposure involves repeated exposure to triggers in an attempt to extinguish cravings and other undesirable responses.
Therapeutic Communities and Rehabilitation Centers
Therapeutic communities usually require several months to years of residence with extensive participation by the clients. Costs for these programs tend to be high and many are criticized as employing outdated treatment methods, but research has found that "low-cost, publicly funded clinics have better-qualified therapists and better outcomes than the high-end residential centers typically used by celebrities like Britney Spears and Lindsay Lohan" (Brody, 2013). Given the relapse rates of addicts who attend "rehab" facilities, some encourage "that most people recover (1) completely on their own, (2) by attending self-help groups, and/or (3) by seeing a counselor or therapist individually" (Brody, 2013).
Relapse Prevention Plans
The development of a relapse prevention plan is often an intended outcome or useful by-product of many of these therapies. More information on building these plans can be found in the top right section of the blog titled: "9 Steps to Building a Relapse Prevention Plan."
References
Brody, J.E. 2013. Effective addiction treatment. Retrieved from http://well.blogs.nytimes.com/2013/02/04/effective-addiction-treatment/.
Luty, J. 2006. What works in alcohol use disorders? Retrieved from: http://apt.rcpsych.org/content/12/1/13.full.pdf.
Rockefeller University. 2005. 'Contingency Management' Improves Addiction Recovery: Program Reinforces Each Small Step Toward Success. Retreived from: http://alcoholism.about.com/od/relapse/a/blru050402.htm
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