Treatment Options for Drinking Problems
Government figures suggest that around 27 per cent of men and 15 per cent of women consume alcohol at rates above the recommended number of weekly units for sensible drinking.
But people falling within this 'danger zone' exhibit a wide range of drinking behaviours. In other words, the excessive consumption of some problem drinkers can be relatively 'light' compared to others.
By necessity, then, the range of treatments available reflects this continuum. In other words, the type of intervention used to tackle problem drinking should be appropriate to the level of the problem and the needs of the individual who is seeking advice or assistance.
Here are some of the options available:
- Brief interventions
Brief interventions are not targeted at individuals who are alcohol dependant, but instead designed to help individuals who are drinking excessively but not yet experiencing serious associated problems. A brief intervention can range from five to ten minutes of information and advice given to an excessive drinker, to two to three sessions of motivational interviewing or counselling.
- Counselling and therapy
Counselling is provided by a variety of services including alcohol advice and counselling services, community alcohol teams, days services and residential services. There are many different kinds. Cognitive Behaviour Therapy (CBT), for example, is recognised widely as an effective method of treatment for alcohol problems, although it appears to be more effective for individuals with less severe problems.
Some people may require detoxification (withdrawal from physical dependence) from alcohol as part of their treatment programme or before they enter residential rehabilitation. Detoxification can be provided in a number of settings including hospital wards, NHS alcohol treatment units, and residential services. Community or home detoxification is also available and is offered by community alcohol teams, some alcohol advice and counselling services or through general practice. Patients who are socially unstable or have more severe alcohol problems have better outcomes in intensive or in-patient programmes, while socially stable patients with less severe problems tend to do better in less intensive or home detox programmes, say experts at Alcohol Concern.
- Day programmes
Day programmes typically offer a structured full-time programme for clients over six weeks to nine months, providing a combination of group work, individual counselling, skills training and relapse prevention work. A study of alcohol services outcomes out by Alcohol Concern concluded that three to12 months after leaving day care, the outcome of maintaining abstinence was achieved by 56% of clients.
- Residential programmes
Residential care for people with alcohol dependency may be may be provided in hospitals, nursing homes, registered care homes or hostel accommodation, but the facility is most commonly provided by the independent, private and not-for-profit sector. Most people use residential rehabilitation after detoxification from alcohol. Programmes are varied in their approach, but usually involve working with the client to help them become more independent, develop new lifestyles and give them the skills to avoid relapse. An Alcohol Concern study that examined follow-up studies by residential services of client outcomes found that between 60 per cent and 92 per cent of clients traced maintained positive alcohol outcomes for periods ranging from six months to four years after leaving treatment.
- Self-help groups
Alcoholics Anonymous (AA) is the most famous network of self-help groups with over 3,000 groups in the UK. AA views alcohol dependency as a disease and total abstinence is required by the programme. Al-Anon is a similar kind of network for relatives and friends of problem drinkers. Secular Organisations for Sobriety (SOS) offers a similar model to AA, but with considerably less emphasis on the 'higher power' aspect. There are other self-help groups, some of which are attached to either residential or non-residential services and provide a means of clients providing support to each other and sharing problems and experiences either during or after treatment.
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