Examples Of Psychological Treatment Approaches

Psychological Treatment Approaches
A broad range of psychological therapies are used to treat alcoholism. Some of the major ones are social skills training, motivational enhancement, behaviour contracting, cognitive therapy, marital and family therapy, aversion therapy and relaxation training. Alcoholism treatment can be highly effective, but the effectiveness depends on a few factors
 Person’s willingness major factor in overcoming alcoholism: The major factor whether alcoholism treatment ends up successfully or not depends greatly on the person’s willingness to participate. An alcoholic who is eager to get his or her life back on track is more likely to follow the program guidelines and work through the most difficult parts of recovery
instead of giving up.
So admitting to the problem is the first step before the start of therapy. Addicts are often brilliant at convincing themselves they don’t have a problem or that they are doing everything to overcome the problem. For instance if they say,
If I drink before 9 am, it doesn’t count.
I will give up tomorrow
These are all examples of ways an alcoholic might try to justify their actions. However these patterns of thought are unhealthy and may make an alcoholic more likely to continue inflicting damage on him or herself.
 Strong Family support /Family Counselling: The level of support the recovering alcoholic gets from others is another factor that can make the difference between success and failure.
Close friends or strong family support or community support can make a huge impact in the process. The whole family gets caught up in the denial and untruth. They sometimes deny that the whole family woes are really all because of alcohol, and tend to be untruthful about the extent to which they enable the alcoholic’s behaviour and ‘getting away with it’ time and again. Although it’s often impossible, counselling of the individual alcoholic is often not enough-the entire immediately family need counselling since the feelings of the alcoholic is transferred to the family members as shown below in the
table

Alcoholic’s feeling Alcoholic’s behaviour Feelings of the alcoholics family members
Guilt, self –hatred Self-righteousness, blaming Guilt, self-hatred
Fear Aggression, anger Fear
Helplessness Controlling of others Helplessness
Hurt Abusiveness Hurt
Loneliness, rejection Rejecting Loneliness, rejection

Behavioural Family Counselling (BFC) involves other family members in the treatment with the individual with the alcohol, drug, or addiction problem.
Depending on the specific needs of each family member, treatment may involve sessions with the whole family, parts of the family, or with only specific family members. In these approaches, the role of interactions with family members are considered key in the maintenance and treatment of substance use disorders. Family therapies are effective in terms of increasing abstinence, reducing use and the consequences of use, improving relationship functioning, and reducing family violence in both male and female clients. The benefits are present up to one year later. Family therapy is more effective than individual drug counselling, and equal to Cognitive Behaviour Therapy in effectiveness. It has added benefits related to other family members, for example, children of parents receiving couples or family therapy improve in psychosocial functioning.

 Community counselling: The goal is to bring together a group of dedicated professionals who would create an array of services that were both culturally sensitive and highly effective in changing behaviour at the individual, group and community levels for bringing mass awareness and sharing the effort among all in combating the problems of persons
addicted.

Psychologists who are trained and experienced in treating alcohol problems can be helpful in many ways. Before the drinker seeks assistance, a psychologist can guide the family or others in helping to increase the drinker's motivation to change. A psychologist can begin with the drinker by assessing the types and degrees of problems the drinker has experienced. The results of the assessment can offer initial guidance to the drinker about what treatment to seek and help motivate the problem drinker to get treatment. Individuals with drinking problems improve their chances of recovery by seeking help early.
These therapies can help people boost their motivation to stop drinking, identify circumstances that trigger drinking, learn new methods to cope with high-risk drinking situations, and develop social support systems within their own communities.

Certain points to be taken care by the Counsellor in due course of the therapy :

Counsellor’s Behaviours Prescribed The counsellor’s role is to motivate, engage, guide, educate, and retain clients during all phases of the program. Using an array of motivational, client-cantered, and problem solving techniques, counsellors are expected to:
• Emphasize the client's strengths rather than weaknesses.

• Join rather than assault (confront) resistance.

• Avoid aggressive confrontation and power struggles.

• Negotiate rather than pontificate treatment goals.

• Emphasize the client's personal responsibility for change.

Counsellor’s Behaviours Proscribed The counsellor is cautioned against being dogmatic and controlling, especially in response to reluctant and resistant clients. It is easy for the counsellor to lose sight of the fact that the first and foremost goal of treatment is to engage the client in a friendly, cooperative, positive interaction that increases the client's willingness to examine and change his or her drug-using behaviour. Counsellors are taught how to avoid the most common therapeutic blunders and negative counter transferential responses with drug-abusing clients. These include:
• Predicting abject failure and misery if the client does not follow the counselor's advice.

• Telling the client that what he or she really needs is more drug-related negative consequences to acquire the motivation for change.

• Ignoring discrepancies between the program's goals and the client's goals.

• Feeling frustrated and angry at clients who do not fully comply with the program.

• Wanting to impose negative consequences on noncompliant clients (e.g., depriving them of further help by "throwing them out of treatment") rather than negotiating a change in a treatment plan based on clarification of the client's ambivalence about change.

Some Standard forms of therapy for alcoholism include:
• Group Therapy
• Interactional group psychotherapy based on the Alcoholics Anonymous (AA) 12-step program
• Cognitive-behavioral therapy
• Combined behavioral intervention
• Behavioural Coupled therapy
• Aversive Conditioning

Comparison studies have reported that these approaches are equally effective when the program is competently administered. Specific people may do better with one program than another.
Group therapy for alcohol addiction allows addicts to help themselves and gain support from the other group members who are facing or who have overcome similar problems to their own. Groups will generally be run by a trained facilitator and will also deal with areas such as improving people’s social skills and teaching them how to cope with their problems instead of turning to alcohol. They can give advice about living without alcohol and also provide education about the dangers of alcohol addiction. Family interventions, lectures and film and video presentations will generally be part of any group therapy programme.

INTERACTIONAL GROUP PSYCHOTHERAPY (ALCOHOLICS ANONYMOUS)
AA, which was founded in 1935, is an excellent example of interactional group psychotherapy. It remains the most well-known program for helping people with alcoholism. AA offers a very strong support network using group meetings open 7 days a week in locations all over the world. A buddy system, group understanding of alcoholism, and forgiveness for relapses are AA's standard methods for building self-worth and alleviating feelings of isolation.
AA's 12-step approach to recovery includes a spiritual component that might deter people who lack religious convictions. AA emphasizes that the "higher power" component of its program need not refer to any specific belief system. Associated membership programs, Al-Anon and Alateen, offer help for family members and friends.
THE 12 STEPS OF ALCOHOLICS ANONYMOUS
• We admit we were powerless over alcohol -- that our lives have become unmanageable.
• We have come to believe that a Power greater than ourselves could restore us to sanity.
• We have made a decision to turn our will and our lives over to the care of God, as we understand what this Power is.
• We have made a searching and fearless moral inventory of ourselves.
• We have admitted to God, to ourselves and to another human being the exact nature of our wrongs.
• We are entirely ready to have God remove all these defects of character.
• We have humbly asked God to remove our shortcomings.
• We have made a list of all persons we had harmed and have become willing to make amends to them all.
• We have made direct amends to such people wherever possible, except when to do so would injure them or others.
• We have continued to take personal inventory and when we were wrong promptly admitted it.
• We have sought through prayer and meditation to improve our conscious contact with God as we understand what this higher Power is, praying only for knowledge of God's will for us and the power to carry that out.
• Having had a spiritual awakening as the result of these steps, we have tried to carry this message to alcoholics and to practice these principles in all our affairs.