Addiction counseling can take many approaches. Some people may have positive experiences with motivational interviewing and others may get results from cognitive behavioral therapy.
But, there are some major theories that come into play and the following discussion should provide some insight.
This may also be called "individual psychology." The practice is holistic. This method of counseling rests on the premise that everyone is moving toward a series of goals or superiority. Because of discouragement or feelings of inferiority, the goals (or the lifestyle they create) may be self-defeating. Therapists work to help patients recognize and use their strengths in order to develop social interest and to lead a more satisfying life.
When using this method with alcoholics, the focus is on identifying and correcting unwise beliefs. These beliefs are often contributing factors to the alcoholism.
This may also be called "behavioral modification. It is a general approach that helps a client alter learned behaviors that are producing negative outcomes in the patient's life. Behavioral counseling has been rigorously tested and researched and has a great record of effective results, particularly with clients who are alcoholics. There are concrete guidelines for assessing treatment progress and emphasis on empowering patients to make behavioral changes on their own.
Other behavioral therapies that share similar root concepts include:
- Contingency Management: Rewards are given for achieved stints of abstinence.
- Assertion Training: Patient learns the skills they need to fight undesirable influences and behaviors in their life.
- Cue Exposure Treatment: Patients are consistently exposed to triggers and cues until they develop coping behaviors.
- Covert Sensitization: The patient imagines using alcohol and then immediately imagines a horrible consequence.
- Aversion Therapy: Alcohol is paired with an unpleasant feeling (like electric shock) with the hope that the patient will associate the two and avoid alcohol to avoid the associated discomfort.
This type of counseling doesn't have a specific theory backing the practice. Instead, the focus is on producing results in a limited amount of time, like what one is given in short-term rehab. Many patients don't have the time or the financial wherewithal to fund lengthier traditional counseling sessions. These, instead, are short, goal-oriented, and directed sessions.
Cognitive Behavioral Counseling
According to the National Institute on Drug Abuse, cognitive behavioral counseling was developed in order to prevent relapse among alcoholics, so its relationship with alcoholism has a long history.
The backing theory states learning processes play a critical role in the development of negative behaviors, like excessive alcohol use.
Patients learn skills that allow them to identify and correct problem behaviors. These skills may also be used to address other problems, as well.
Community Reinforcement Counseling
Community reinforcement approach plus vouchers is a 24-week outpatient counseling program used to treat people with alcohol and cocaine use disorders. It works to make a sober life more rewarding that the life a patient leads when drinking. This is done using:
- Recreational Reinforcers
- Familial Reinforcers
- Social Reinforcers
- Vocational Reinforcers
- Material Incentives
According to the National Institute on Drug Abuse, there are two treatment goals:
- To maintain sobriety long enough for patients to learn the new life skills they need to sustain it.
- To reduce alcohol consumption for patients whose alcohol use is linked to cocaine use.
This program is particularly successful when alcoholism is just one of multiple addictions.
12 Step Facilitation Counseling
12 step counseling promotes abstinence for alcohol (among other abused substances) by asking patients to engage actively with 12 step self-help groups.
The National Institute on Drug Abuse identifies the approaches three main ideas:
Acceptance, which includes the recognition that alcohol addiction is a chronic, ongoing disease over which one does not have control, that life has become uncontrollable because of alcohol, that willpower by itself is inadequate to surmount the problem, and that sobriety is the only alternative.
Surrender, which includes giving oneself to a higher power, receiving the fellowship and support of other recovering addicts, and adhering to the recovery activities laid out by the 12-step group.
Active Participation in 12-step meetings and associated activities.
The efficacy of treating alcoholism with 12 step groups is well-documented. As the longest running 12 step group, Alcoholics Anonymous is one of the most popular 12 step groups. It has been a vital tool in fighting alcohol addiction for millions of people.