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16 - Complex interventions for alcohol use disorders

from Part III - Specific treatments

Published online by Cambridge University Press:  12 May 2010

By
Valerie J. Slaymaker ,
Kirk J. Brower  and
Mike Crawford
Edited by
Peter Tyrer  and
Kenneth R. Silk
Valerie J. Slaymaker
Affiliation:
Hazelden Foundation Center City, MN USA
Kirk J. Brower
Affiliation:
University of Michigan Addiction Research Center Rachel Upjohn Building Ann Arbor, MI USA
Mike Crawford
Affiliation:
Department of Psychological Medicine Imperial College London Claybrook Centre Charing Cross Campus London UK
Peter Tyrer
Affiliation:
Imperial College of Science, Technology and Medicine, London
Kenneth R. Silk
Affiliation:
University of Michigan, Ann Arbor
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Summary

Editor's note

Alcohol misuse is a complex problem and complex interventions are the norm in its management. This is illustrated well in this chapter in which all the effective treatments are not just complex, but often multi-complex, and it is not always certain what constitutes the most important elements. It is also important to note that the result of an intervention may differ at different levels of dependence. ICD-10 defines a category of ‘harmful use’ that is short of full dependence, and many of the simpler interventions may be more helpful in this group than when full dependence has developed.

Introduction

A complex intervention for alcohol use disorders may be defined as one that utilizes multiple therapeutic components and strategies, based on a common underlying philosophy of treatment and targeted at various facets of the disorder in a complementary and frequently simultaneous fashion. Most treatment for moderately to severely alcohol-dependent patients is complex by this definition and for good reasons. First, alcohol use disorders are heterogeneous and influenced by multiple factors in terms of their etiology, development, and course. Second, no single treatment strategy or technique is effective across all alcohol-dependent patients. Third, the active ingredients of most, if not all, psychosocial therapies for alcohol dependence are unknown.

This chapter will cover four complex interventions for which there is a base of evidence to evaluate them. They are Alcoholics Anonymous (A.A.), the Minnesota Model of treatment, Therapeutic Communities (TCs), and combined pharmacotherapy and psychotherapy.

Type
Chapter
Information
Cambridge Textbook of Effective Treatments in Psychiatry , pp. 320 - 339
Publisher: Cambridge University Press
Print publication year: 2008

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  • Complex interventions for alcohol use disorders
    • By Valerie J. Slaymaker, Hazelden Foundation Center City, MN USA, Kirk J. Brower, University of Michigan Addiction Research Center Rachel Upjohn Building Ann Arbor, MI USA, Mike Crawford, Department of Psychological Medicine Imperial College London Claybrook Centre Charing Cross Campus London UK
  • Edited by Peter Tyrer, Imperial College of Science, Technology and Medicine, London, Kenneth R. Silk, University of Michigan, Ann Arbor
  • Book: Cambridge Textbook of Effective Treatments in Psychiatry
  • Online publication: 12 May 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544392.018
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  • Complex interventions for alcohol use disorders
    • By Valerie J. Slaymaker, Hazelden Foundation Center City, MN USA, Kirk J. Brower, University of Michigan Addiction Research Center Rachel Upjohn Building Ann Arbor, MI USA, Mike Crawford, Department of Psychological Medicine Imperial College London Claybrook Centre Charing Cross Campus London UK
  • Edited by Peter Tyrer, Imperial College of Science, Technology and Medicine, London, Kenneth R. Silk, University of Michigan, Ann Arbor
  • Book: Cambridge Textbook of Effective Treatments in Psychiatry
  • Online publication: 12 May 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544392.018
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  • Complex interventions for alcohol use disorders
    • By Valerie J. Slaymaker, Hazelden Foundation Center City, MN USA, Kirk J. Brower, University of Michigan Addiction Research Center Rachel Upjohn Building Ann Arbor, MI USA, Mike Crawford, Department of Psychological Medicine Imperial College London Claybrook Centre Charing Cross Campus London UK
  • Edited by Peter Tyrer, Imperial College of Science, Technology and Medicine, London, Kenneth R. Silk, University of Michigan, Ann Arbor
  • Book: Cambridge Textbook of Effective Treatments in Psychiatry
  • Online publication: 12 May 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544392.018
Available formats
×