Nick Heather

Northumbria University, UK

Although there has been much recent interest in various forms of pharmacotherapy for alcohol problems, treatment in this field has traditionally consisted of 'talk therapy' and this remains true today. Beginning in the 1930s, medical interest in treating alcohol problems lagged behind the efforts of 'recovering alcoholics' to help each other in the classic mutual-aid group, Alcoholics Anonymous (AA). Following a growing recognition of the individual and social harm caused by alcohol dependence during the 1950s, the medical response continued to be based on the model of recovery pioneered by AA. Subsequently, the influence of more professionally based forms of psychotherapy began to appear, including during the 1960s and 1970s treatment modalities based on theories of learning developed by psychologists. This last has been the dominant general influence on professional treatment up to the present day.

The most important recent development in the way alcohol problems are conceptualised has been a shift from an exclusive preoccupation with 'alcoholism' (severe alcohol dependence) to a 'broadening of the base' of treatment (Institute of Medicine, 1990) to include the very large number of people in society who damage their own or others' health and welfare, or risk doing so, because of their excessive consumption of alcohol. This has resulted in great interest in the potential benefits of 'brief interventions' for hazardous and harmful drinking delivered by generalist workers to individuals who are not seeking help for alcohol problems and whose problems, even if they have become manifest, are typically early and mild (Heather, 2003; Heather & Kaner, 2003). Thus these brief interventions are offered mainly in the interests of early intercession and secondary prevention. Since brief interventions of this sort can be as short as 5 to 10 minutes in duration, it might seem odd to include them in a chapter concerned with psychotherapy for alcohol problems. However, to omit brief interventions would fail to give a true picture of the current response to alcohol-related harm. Moreover, as we shall see, some of the principles that have influenced the content and style of brief interventions would be familiar to practitioners of psychotherapy proper.

For these reasons, this chapter will include attention to brief interventions. Also included will be modern approaches to treatment that rely to a varying extent on the client's social network to bring about change. In more general terms, the rough definition of psychotherapy used in this chapter is any form of interaction between helper and helped in which language

Handbook of Evidence-based Psychotherapies: A Guide for research and practice. Edited by C. Freeman & M. Power. Copyright © 2007 John Wiley & Sons, Ltd.

is the predominant means of bringing about a change in behaviour, including modalities that are primarily seen as 'performance based'. As an illustration, this definition excludes aversion therapy, electrical or chemical, but includes 'covert sensitisation therapy' (Rimmele, Howard & Hilfrink, 1995) in which aversive conditioning is thought to proceed in imagination, prompted by the therapist's verbal suggestions. For obvious reasons, detoxification will not be considered beyond the observation that by itself it has little or no long-term effect on alcohol problems.

Beat The Battle With The Bottle

Beat The Battle With The Bottle

Alcoholism is something that can't be formed in easy terms. Alcoholism as a whole refers to the circumstance whereby there's an obsession in man to keep ingesting beverages with alcohol content which is injurious to health. The circumstance of alcoholism doesn't let the person addicted have any command over ingestion despite being cognizant of the damaging consequences ensuing from it.

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