Alcohol: Types of Psychotherapy to Treat Alcoholism

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Alcohol:  Types of Psychotherapy to Treat Alcoholism




Guest:  Dr. Sarah Book – Psychiatry & Behavioral Sciences

Host:  Dr. Linda Austin – Psychiatry


Dr. Linda Austin:  I’m Dr. Linda Austin.  I’m interviewing Dr. Sarah Book, Psychiatrist, Center for Drug and Alcohol Programs.  Dr. Book, when somebody with an alcohol problem comes for treatment, what should they expect?


Dr. Sarah Book:  There are lots of different types of alcohol treatments.  In our program, at the medical university, we use essentially three different types of psychotherapies that I think are representative of therapies that people would receive at different centers.


Dr. Linda Austin:  Let’s take them one by one.  What are those types?


Dr. Sarah Book:  The first kind of therapy we use is cognitive-behavioral therapy, where a therapist helps an individual look at the thoughts that go into their behavior of drinking and how the alcohol actually changes the thoughts, or how thoughts themselves might lead to alcohol use, and also how individual’s emotions get involved with alcohol use, and helps an individual to kind of look at that as a cycle and figure out a way to break that cycle.


Dr. Linda Austin:  So it really is an exploration of one’s thoughts and the thought patterns, how one thing leads to another?


Dr. Sarah Book:  That’s exactly right.


Dr. Linda Austin:  So it might be, for example, I would say to you, “Gee, I get stressed and I reach for a glass of wine”?


Dr. Sarah Book:  Right.


Dr. Linda Austin:  And then you say?


Dr. Sarah Book:  “What are other alternative behaviors that you could engage in for that stress?”  Also, we would say, “Let’s look at the effect of having that drink has on your stress, both the short term effect as well as the long term effect.”


Dr. Linda Austin:  Dr. Book, what is the second form of psychological treatment?


Dr. Sarah Book:  We also offer a type of therapy called Motivational Enhancement Therapy.  You know, Linda, not everyone who comes into treatment for alcoholism is really ready.  They may be coming into treatment because somebody else wants them to come to treatment.  So we use this type of therapy which essentially helps to enhance an individual’s motivation to participate in treatment.


Dr. Linda Austin:  What about the third form of therapy?


Dr. Sarah Book:  The third type of therapy is something that our listeners are probably more familiar with, which is what we call Twelve Step Facilitation Therapy, which is a type of therapy that starts to introduce individuals to Alcoholics Anonymous and the twelve steps that are used in AA.


Dr. Linda Austin:  So then, can you do AA, participate in AA, and participate in cognitive-behavioral therapy?


Dr. Sarah Book:  Absolutely. 


Dr. Linda Austin:  Is that typical?


Dr. Sarah Book:  We encourage that.


Dr. Linda Austin:  And can you do those two things and use a medication, such as Rivea or Campral?


Dr. Sarah Book:  Yes, you definitely can.  And that is the treatment setting in which those medications have been shown to be effective.


Dr. Linda Austin:  What is the role of the family in treatment?


Dr. Sarah Book:  In our program, and again, our program is going to be similar to other programs around the country, we like to involve the family in treatment.  Not only are families going to affect a person’s motivation and what we call cues to drink.  Families can also give us information about an individual that the individual may not be able to give us.


Dr. Linda Austin:  One of the things that you hear a lot, that I’d love for you to comment on, is a family member who says, Oh, my sister, my husband, my son, whatever, my uncle, was in treatment.  We tried treatment and it just didn’t work; he/she started drinking again.  What do you say in response to that?


Dr. Sarah Book:  Well, alcoholism is a chronically recurring problem.  Some individuals enter treatment and they are able to maintain sobriety for 20, 30 years, or for the rest of their life.  Then, for others, it’s just not as simple, and they may need repeated attempts at treatment before they can find sobriety.


Dr. Linda Austin:  Dr. Sarah Book, thank you so much for talking with us today.


Dr. Sarah Book:  Thank you, Linda.


If you have any questions about the services or programs offered at the Medical University of South Carolina or if you would like to schedule an appointment with one of our physicians, please call MUSC Health Connection:  (843) 792-1414.


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