Problem Drinkers Guided Self-Change Treatment

by Sobell, Mark B.; Sobell, Linda Carter

• ISBN13: 9780898622126
• ISBN10: 0898622123
• Format: Hardcover
• Copyright: 1993-06-01
• Publisher: The Guilford Press

Summary

While chronic alcoholics receive the greatest amount of attention--both clinically and in the public eye\m-\problem drinkers actually constitute the majority of people who have trouble dealing with alcohol. Problem drinkers have identifiable life difficulties due to their drinking but are not severely dependent on alcohol: They do not drink every day; they often can maintain control of their drinking when they do; and they do not suffer withdrawal symptoms. Considerable evidence now exists showing that treatment programs designed for alcoholics are completely inappropriate for dealing with problem drinkers. Addressing the needs of this specific population, this book presents an empirically based program of state-of-the-art motivational interventions.

Author Biography

Mark B. Sobell, Ph.D., is a Senior Scientist and Associate Director for Treatment Research and Development at the Clinical Research and Treatment Institute of the Addiction Research Foundation in Toronto, Canada. In addition, he is a Professor in the Departments of Psychology and Behavioural Science at the University of Toronto.
Linda C. Sobell, Ph.D., is a Senior Scientist, Assistant Director for Research and Clinical Training, and Chief of the Guided Self-Change Unit at the Clinical Research and Treatment Institute of the Addiction Research Foundation in Toronto, Canada. In addition, she is a Professor in the Departments of Psychology and Behavioural Science at the University of Toronto, and is currently the President-elect of the Association for Advancement of Behavior Therapy.

Table of Contents

Treatment Approaches to Alcohol Problems	1	(10)
The Evolution of Approaches to the Treatment of Alcohol Problems	1	(1)
Some Key Issues	2	(3)
The Role of Outpatient Services	5	(3)
Nonintensive Outpatient Treatments	8	(3)
The Recognition of Problem Drinkers	11	(6)
Are Alcohol Problems Progressive?	11	(2)
Prevalence of Problem Drinkers	13	(4)
A Closer Look at Problem Drinkers	17	(9)
Studies of Problem Drinkers	17	(1)
Problem Drinkers in the Research Literature	18	(4)
A Close Look at a Group of Problem Drinkers	22	(4)
Treatment of Problem Drinkers: The Missing Part of a Comprehensive Approach to Alcohol Problems	26	(11)
Concordance of Advances in the Alcohol Field and in Behavior Therapy	26	(1)
Treatments for Problem Drinkers: Issues	27	(5)
Treatments for Problem Drinkers: Evaluations	32	(5)
A Self-Change Approach to Treating Problem Drinkers	37	(15)
Development of a Treatment Tailored to Problem Drinkers	38	(1)
Nonintensive Treatment	38	(2)
Motivational Interventions	40	(1)
Selection of Treatment Goals	41	(2)
Cognitive Relapse Prevention in Guided Self-Management Treatment	43	(4)
Evaluations of Relapse Prevention	47	(4)
Summary and Integration	51	(1)
Assessment: A Running Start	52	(17)
Entering Self-Management Treatment	52	(2)
Assessment as a Therapeutic Process	54	(3)
Selected Assessment Tools and Procedures	57	(12)
Treatment Procedures: Preparation, Goal Setting, Monitoring Drinking	69	(15)
The Need for Flexibility	69	(1)
Preparing for Treatment Sessions: The Client's Obligations	70	(1)
Preparing for Treatment Sessions: The Therapist's Obligations	70	(1)
Starting the First Session: Setting the Tone	71	(1)
Goal Setting	71	(2)
Alcohol Education	73	(2)
Making the Point about Tolerance	75	(1)
Discussing the Goal Statement with the Client	76	(1)
Filling Out the Goal Statement	77	(2)
Self-Monitoring	79	(5)
Appendix 7.1. Blank Goal Statement Form	81	(2)
Appendix 7.2. Blank Daily Alcohol Monitoring Form	83	(1)
Treatment Procedures: Readings and Conceptual Framework	84	(20)
Reading 1	85	(5)
Introducing Reading 2	90	(1)
Reading 2	91	(13)
Appendix 8.1. Reading 1	93	(6)
Appendix 8.2. Reading 2	99	(5)
Homework Assignments	104	(21)
Homework Assignment 1	104	(4)
Homework Assignment 2	108	(2)
Some Aids for Completing and Discussing the Homework Assignments	110	(1)
Aids for Clients	111	(14)
Appendix 9.1. Homework Assignment 1	113	(5)
Appendix 9.2. Homework Assignment 2	118	(7)
An Integrated Treatment Program	125	(5)
The Course of Treatment	126	(4)
Assessment	127	(1)
Session 1	128	(1)
Session 2	128	(1)
Session 3	129	(1)
Session 4	129	(1)
Case Examples	130	(24)
Heavy Drinking Related Primarily to Negative Affective States	131	(4)
Heavy Drinking Related Primarily to Positive Affective States and Social Pressure Situations	135	(5)
Heavy Drinking Related Primarily to Positive Affective States	140	(3)
Heavy Drinking Related to Testing Personal Control	143	(5)
Heavy Drinking Across Most Situations	148	(6)
Outcomes and Afterthoughts	154	(14)
The Topography of Outcomes	155	(2)
Client Perceptions of Guided Self-Management	157	(7)
Therapist Perceptions of Guided Self-Management	164	(2)
On Implementing Guided Self-Management Treatment in Clinical Practice	166	(2)
References	168	(15)
Index	183