Alcoholism CBT

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ALCOHOLISM is the continued consumption of alcoholic beverages despite the health problems and negative social consequences it causes… It is estimated that:
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COGNITIVE BEHAVIORAL THERAPY An alcoholism treatment approach aimed at improving the patients’ cognitive and behavioral skills for changing their drinking behaviour
(Longabaugh & Morgenstern, 1999)

 First

alcoholism treatment approach to demonstrate efficacy in reducing drinking in randomized clinical trials.1 studies and reviews have ranked CBT among the most effective approaches for treating alcoholic patients.2

 Numerous

One in every TEN people who drink are alcoholic 15.1 M of all alcoholics in the United States are WOMEN Abused by 81% of the population of the United States

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Alcoholism leads to:
    

49% of murders
21% of suicides 60% of child abuse 90% of ALL property crimes 90% of street muggings

1. CBT is guided by the Bandura’s Social Cognitive Theory that an individual’s inability to cope with life stress permeates the drinking behavior.3 2. CBT finds ways to help the individual cope with life’s stressors in a manner that is PRODUCTIVE and HEALTHY. 2

The rapidly expanding problem of alcoholism in the U.S. along with its devastating outcomes creates the need to find an immediate and at the same time effective solution for alcoholism
National Institute on Alcohol Abuse and Alcoholism (NIAAA)

CBT effectively helps patients in:  Managing their cravings  Controlling anger (as anger is considered an antecedent for alcohol use)  Restraining negative thoughts  Making good decisions  Refusing requests (to drink)  Handling criticism  Attaining better social skills
(Kadden, 2002)

Patients who receive CBT as a component of a more comprehensive ongoing treatment are likely to have better drinkingrelated outcomes than patients who do not receive CBT.4 A study conducted on Irish Navy recruits undergoing a 16-week basic training course revealed that participants who received CBT were more prepared to change drinking behaviors, and had lower incidence of binge drinking.5

Pharmacologic Treatment

   

NALTREXONE - blocks effects of alcohol in the brain and reduces alcohol cravings DISULFIRAM (Antabuse) - makes the individual sick when s/he consumes alcohol ACAMPROSATE (Campral) - relieves discomfort that accompany alcohol withdrawal SSRI (Selective - Serotonin Reuptake Inhibitors) - to treat depression, which is a common cause of alcoholism

These studies reveal that Cognitive Behavioral Therapy is:

 effective in reducing and managing
unhealthy drinking behaviors.  prevent relapses from treatment  effective as a stand-along or an adjunct treatment to existing pharmacologic measures in managing alcoholism.

CBT views alcoholism as a learned behavior that is acquired through experience. If drinking alcohol gives an individual pleasure repeatedly, it may become the preferred way of achieving those results, especially if the individual cannot find any other way of achieving such ends, and —treatment for such cannot be achieved by drugs alone...
(Kadden, 2002)

JOURNAL SOURCES:
1. Chaney, E.F., et al. (1978). .Skill training with alcoholics. Journal of Consulting and Clinical Psychology 46:1092–1104, 1978 2. Longabaugh, R. and Morgenstern, J. (1999). Cognitive-Behavioral Coping-Skills Therapy for Alcohol Dependence: Current Status and Future Directions. Alcohol Research & Health. 23 (2); 78 - 85 3. Abrams, D., & Niaura, R. (1987). Social learning theory. In: Blanke, H.T., and Leonard, K.E., eds. Psychological Theories of Drinking and Alcoholism. New York: Guilford Press, pp. 131–178 4. Jaffe, A., Rounsaville, B., Chang G., Schottenfield, R., Meyer, R.; & O’malley, S. (1996). Naltrexone, relapse prevention, and supportive therapy with alcoholics: An analysis of patient treatment matching. Journal of Consulting and Clinical Psychology 64:1044–1053. 5. McCarthy, P. and O’Sullivan, D (2010). Efficacy of a brief cognitive behavioral therapy program to reduce excessive drinking behavior among new recruits entering the Irish Navy: a pilot evaluation.Military Medicine. 175(11):841-6.

The potentials of Cognitive Behavior Therapy is a fertile ground for future research directions.

 Broaden the scope of CBT to include
self-help groups and pharmacotherapeutic modalities  Make CBT more available and accessible to alcoholics through advocacies and other means of raising awareness.

OTHER SOURCES:
1. Kadden, R. (2002). Cognitive-Behavior Therapy for Substance Dependence: Coping Skills Training. http://www.bhrm.org/guidelines/ CBT-Kadden.pdf accessed March 1, 2012.

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