Specialized Treatment

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Specialized Treatment
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Objectives

• Participants will have
• general knowledge of the scientific basis for
  alcohol treatment methods
• increased understanding of the various types of
  specialized alcohol treatment programs
• increased understanding of the community
  resources available to assist persons adversely
  affected by alcohol use disorders

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Outcome Research

• Project MATCH
• 30 abstinent at one year
• 40 significantly decreased their drinking days
  and drinks per drinking day
• Special populations such as physicians had 5-year
  abstinence rates of over 80

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Treatment Modality 1 Brief Intervention

• Reduced alcohol use
• Reduced hospital days
• Effective with women

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Treatment Modality 2 Broad Spectrum Skills
Training

• Social skills training
• Community reinforcement
• Systematic desensitization

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Treatment Modality 3 Marital/Family Therapy

• Primary method is cognitive behavioral therapy

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Treatment Modality 4 Cognitive Behavioral
Approaches

• Behavior contracting
• Self-help manuals
• Cognitive therapy
• Behavioral self-control training
• Relapse prevention
• Functional analysis
• Self-monitoring
• Basic discrimination training

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Treatment Modality 5 Aversion Therapies

• Nausea aversion
• Covert sensitization
• Electrical
• Apneic

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Treatment Modality 6 Pharmacotherapy
Traditional

• Disulfiram
• Calcium carbamide
• Metronidazole
• Antabuse

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Treatment Modality 6 Pharmacotherapy
New

• Serotonin uptake inhibitors (Prozac)
• Naltrexone
• Acamprosate
• Ketamine

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Treatment Modality 7 Psychotherapies

• Individual psychotherapy
• Group psychotherapy
• Client-centered therapy

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Treatment Modality 8 Confrontational Approaches

• Used to break through denial and to facilitate
  behavioral change

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Treatment Modality 9 Standard Treatment
Components

• Milieu therapy
• General alcoholism counseling
• Educational lectures and films
• Alcoholics Anonymous

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Treatment Modality 10 Additional Methods

• Acupuncture
• Exercise
• Hypnosis
• Sensory deprivation

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Twelve Step-Based Treatment Models

• Key treatment components
• Cognitive
• Emotional
• Behavioral
• Social
• Spiritual
• Bibliographical

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Motivational Enhancement Therapy

• Key Components
• Express empathy
• Develop discrepancy
• Avoid argumentation
• Roll with resistance
• Support self-efficacy

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Cognitive Behavioral Coping Skills Therapy

• Key components
• Assessing high-risk situations
• Coping with cravings and urges to drink
• Managing thoughts about alcohol and drinking
• Problem solving
• Drink refusal skills
• Planning for emergencies and coping with a relapse

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Inpatient Alcohol Treatment in a Hospital or
Residential Treatment Program

• Admission criteria
• Health problems
• Failure to maintain sobriety after appropriate
  outpatient treatment
• Major unstable psychiatric illness
• Absence of social support
• Resources available

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Inpatient Treatment Structure

• Daily group meetings
• Daily lectures
• Daily individual counseling
• Family therapy sessions
• Daily activity therapy
• Daily 12-Step meetings
• Meditation
• Journals

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Outpatient Treatment

• Admission criteria
• Absence of serious health or psychiatric problems
• Drug withdrawal completed
• Social support system is available
• Ability to abstain from mood altering drugs and
  alcohol

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Outpatient Treatment Structure

• Group sessions
• Lectures and videos
• Individual counseling
• Family involvement
• Urine drug screening
• Evening meeting times