Medical Health Encyclopedia

AA's 12-step approach to recovery includes a spiritual component that might deter people who lack religious convictions. Prayer and meditation, however, have been known to be of great value in the healing process of many diseases, even in people with no particular religious assignation. AA emphasizes that the "higher power" component of its program need not refer to any specific belief system. Associated membership programs, Al-Anon and Alateen, offer help for family members and friends.

Cognitive-Behavioral Therapy

Cognitive-behavioral therapy (CBT) uses a structured teaching approach and may be better than AA for people with severe alcoholism. Patients are given instruction and homework assignments intended to improve their ability to cope with basic living situations, control their behavior, and change the way they think about drinking. The following are examples of approaches:

• Patients might write a history of their drinking experiences and describe what they consider to be risky situations.
• They are then assigned activities to help them cope when exposed to "cues" (places or circumstances that trigger their desire to drink).
• Patients may also be given tasks that are designed to replace drinking. An interesting and successful example of such a program was one that enlisted patients in a softball team; this gave them the opportunity to practice coping skills, develop supportive relationships, and engage in healthy alternative activities.

Text Continues Below

---

CBT may be especially effective when used in combination with opioid antagonists, such as naltrexone. CBT that addresses alcoholism and depression also may be an important treatment for patients with both conditions. Interestingly, however, in one study patients with alcoholism and social phobias had a poorer outcome with a CBT program that addressed both problems.

Motivational Interviewing