Individual help
This is usually in the form of counselling and various forms of psychotherapy. The basic idea is to talk through the problem of drinking and associated problems to try to help the person change. It is done in different agencies in different ways, some adopting a particular style of psychotherapy - for example, a behavioural approach where behavioural self-control techniques are taught, whilst others work eclectically.Group help
This is usually offered either in the form of an Alcoholics Anonymous (AA) group, Narcotics Anonymous (NA) or one derived from it, or in a therapeutic group. AA groups offer self-help and support through members sharing their own experiences with other ‘sufferers’.For example, AA is strongly associated with the disease concept of ‘alcoholism’, and uses the twelve-step approach (also known as the Minnesota Approach)
AA methods revolve around a combination of group pressure, group cohesion, and caring. Many people find AA almost evangelical, and it has both the benefits and the drawbacks of that: it can turn people away, or it can lead to great commitment to the group and to the philosophy. AA believes that total abstinence is the only goal when working with ‘alcoholics.
AA has helped many people throughout the world to stop drinking and although it has proved a difficult organisation to evaluate, anything which works must be applauded. But its fundamental tenets - that alcoholism is an incurable disease, that people with alcohol problems have no control over their lives, and so on, are contrary to many beliefs.
There also are many types of non-AA therapeutic groups, including ones orientated towards providing social skills, insight into problems, coping with an alcohol-free lifestyle, confrontation, and education about alcohol.
Marital, relationship, and family work
Again, there are many types, although most share the philosophy of seeing alcohol problems in the context of an individual’s relationships.These forms of help may be offered in differing settings:
In-patient treatment usually consists of residential rehabilitation either in therapeutic communities or ‘Twelve step’ Minnesota model houses. Almost all residential abstinence programmes for drug users follow a very traditional pattern, whether religious or secular. The ideal is to take the user away, out of their usual environment, far from friends and all known networks of supply. Once there the user is rapidly weaned off all drugs (usually with the exception of tobacco, which is generally the most difficult addiction of all to break), and then integrated into a supportive community of former drug users under staff supervision.
Community approaches. An alternative to residential rehab is community support. Community teams usually consist of a social worker, a community psychiatric nurse and administrative staff, working with a consultant psychiatrist, often with a link to a local family doctor. GPs are increasingly involved in seeing drug users.
Team roles can include assessment and counselling, detoxification and prescribing, advocacy, child protection, complementary therapy, writing of court reports and liaison with the criminal justice system, with clinics, probation officers and referrals to other services. However, most teams emphasise harm reduction, with abstinence as the ideal eventual goal. The fact is that supervision is almost impossible in the community. Living at home carries a daily risk that the person will wander out down the road and come back intoxicated or with fresh supplies.
(published with permission in writing from:http://addiction.ie)
