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Most people believe that when people feel bad enough, they will want to change.

This is simply not true in alcohol rehabilitation or treatment for alcohol abuse and dependence: discomfort does not bring about change in behaviour. By behaviour, what is meant is the amount of alcohol consumed and the pattern of drinking.

In Australia, the Department for Health and Ageing employs the principles of Cognitive Behaviour Therapy (CBT) and Motivational Interviewing (MI) as part of their intensive treatment interventions for moderate to severe alcohol abuse and alcohol dependence.

In CBT, the way we think affects the way we act and our experiences shape the way we think. Thus, thoughts, feelings and behaviour are interrelated.

In MI, the therapist expresses empathy, but seeks, through question and answer, to develop a discrepancy in the mind of the patient. That is, when the patient does not perceive a need to reduce or stop his drinking, the therapist raises doubt to increase the patient’s perception of risk and problems with his current behaviour.

Once the patient is aware of the risks of his drinking, he might still be ambivalent about changing his drinking habits and patterns. Again, the therapist, using question and answer, evokes from the patient his reasons to change, his perceptions about not changing and his sense of power to change.

When a patient is still ambivalent, the therapist, through question and answer, must allow the patient to weigh the benefits and costs of changing as against not changing his drinking patterns.

The therapist also leads the patient to imagine how he would go about changing his drinking habits if he were to change. The therapist must lead the patient to assess his strengths, give information and advice and to visualize possibilities if he were to change.

When the patient has come to the point that he is willing to change, he must work with the therapist to determine the best course of action to take in seeking change. He must commit to a plan of action to change his drinking habits and he must take the first step in changing his drinking habits.

This is roughly what motivational interviewing and cognitive behaviour therapy does for those patients who abuse alcohol or are dependent on alcohol. CBT and MI are used along with relapse prevention strategies, medication and self-help approaches. 

References:

Haber, P., Lintzeris, N., Proude, E., and Lopatko, O. (2009). ‘Quick reference guide to the treatment of alcohol problems: Companion document to the guidelines for the treatment of alcohol problems’ ,

Disclaimer : This article is just a summary of the subject matter being discussed and should not be regarded as a comprehensive legal advice for you to defend yourself alone. If you are charged with criminal offences, it is recommended that you seek legal assistance from criminal lawyers.

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