Running head: EFFECTS AND TREATMENT

Effects and Treatment of Alcohol Abuse: A Need for More Than One Perspective Lauren Rojas Nevada State College

EFFECTS AND TREATMENT Abstract This paper discusses various psychological and therapeutic treatments that can be implemented in the course of treatment for an individual that abuses alcohol. Alcohol abuse affects the individual as well as the family unit. The individual receiving treatment may have low selfesteem and the goal of the treatment is for the individual to cope properly with negative issues and to become more positive. The various treatments discussed have been shown to positively impact alcoholic individuals as well as their families.

EFFECTS AND TREATMENT Effects and Treatment of Alcohol Abuse: A Need for More Than One Perspective Individuals suffering from alcohol abuse that wish to change this behavior must make improvements and changes to many parts of their lives. Alcohol abuse and dependence affect

around ten percent of our population (McKay & Hiller-Sturmhofel, 2011). 4.5% of this group is classified as alcohol abusers (McCrady, 2012). These statistics show that treatment is needed for those who abuse alcohol. Long-term abuse of alcohol harms the mind and body. Those who abuse alcohol may face jail time because of unlawful actions. This affects the individuals job and family relationships. Individuals who want to receive help for their alcohol abuse must seek help from multiple places of treatment. These treatments range from medical to psychological, by learning new behaviors and thoughts. Finally, individuals must work on family relations and self esteem with counseling. Individuals must also address treatment within their family. Alcoholism negatively affects the abuser and their family; this causes a dysfunction that must be corrected for a positive family life. According to Patrick and Schlenberg (2011) individuals reason their actions and plan behaviors, this reasoning includes drinking. Certain behaviors will lead to specific consequences, these behaviors will come to fruition based on the value these behaviors have. For example, if an individual is facing negative family issues such as divorce or physical abuse, they may choose to retreat from these issues by drinking. This drinking allows the person to not face the reality of their life and they may feel better by not dealing with their family problems. The individual values the behavior of drinking because it is a source of positivity for them. In this example, drinking is a learned behavior. It is also something that can be changed in the clients life. The client can learn to deal with their issues by facing them and abusing alcohol will no longer be

EFFECTS AND TREATMENT needed. As an individual continues to drink, the mind and body become damaged; this can lead to further psychological distress in the life of the client and their family. Excessive drinking can cause physical damage to an individuals brain (Crews, 2008). Alcoholic neurodegeneration results in a loss of structure and function of the neurons. Since the

brain is physically changed there can be dysfunctional behavior in the person who abuses alcohol (Crews, 2008). The individual may also have reduced cognitive ability due to drinking and their judgments may suffer because of this inability. Since there may be reduced cognition and reasoning in someone who abuse alcohol, the individual could possibly make choices that will cause them to get into trouble. If an individual chooses to drink and then operate a vehicle they could get arrested for this act. After multiple offences the alcoholic may be sent to prison and they might lose their job. Family relationships will suffer because of this negative consequence. Treatment, ideally, should be sought before situations like these occur. Treating an individual who abuses alcohol requires more than one perspective. The individual is affected by the act of alcohol abuse. The family is also negatively affected because of this. The individual must work on improving their relationships with family members as well as change their behaviors and thoughts related to alcohol abuse. Alcohol abuse can be treated from a psychological approach as well as a counseling approach. Both disciplines treat the individuals very important needs as well as address the problem of alcohol abuse from different viewpoints. Cognitive behavioral therapy is a technique used to treat those who abuse alcohol. Cognitive behavioral therapy, in regards to alcoholism, allows an individual to identify thoughts related to alcohol, evaluate support systems in place, and to write a plan for relapse prevention (Cooper, 2012). It is extremely important for a person with alcohol addiction to identify and

EFFECTS AND TREATMENT understand what thoughts or feelings make them want to drink. The better these negative thoughts can be controlled, the more the individual will be able to abstain from drinking. Locus of control is another factor that affects drinking behaviors for those who abuse alcohol (Balgojevic-Damasek, Frencl, Perekovic, Cavajda & Kovacek, 2012). Individuals can realize they control their drinking habits and efforts to stop drinking, which is internal locus of control, or they can display an external locus of control. Alcoholics may blame others for their drinking habits, such as not having a strong support system in place, this act of blaming displays external locus of control (Balgojevic-Damasek et al., 2012). Thoughts influence an individuals behaviors. When an individual who abuses alcohol is able to resist those urges to drink they are on a positive path to change. Individuals must learn new coping skills to replace alcohol abuse. These skills should be helpful to the individual as well as safe. According to Dr. Brad Donohue, cognitive behavioral therapy functions to motivate the client and reinforce within the client positive thoughts and behaviors for their sobriety (personal communication, October 31, 2013). Cognitive behavioral therapy sets goals with the individual

for them to accomplish. Goals may include reducing the amount of alcohol used on a daily basis. Clients may go from drinking a full bottle of alcohol a day to a half. This positive change in drinking habits is a fantastic accomplishment. Clients must aim to learn to accept themselves. An individual may become upset at the fact they have an urge to drink alcohol. They must learn that these feelings are normal for them to have. The individual should not dwell on things they cannot change, such as others drinking around them. Acceptance based therapy is another psychological aspect of treatment that works with cognitive behavioral therapy. Cognitive behavioral therapy aims to regulate behavior and thoughts with regard to alcohol use. Acceptance-based therapy can possibly help with increasing

EFFECTS AND TREATMENT the tolerance of alcohol cravings, as well as emotional, psychological and cognitive stress

(Vieten, 2010). If an individual is more accepting of their cravings while going through treatment they may feel like they are part of the solution (D. Donohue, personal communication, October 31, 2013). As the individual learns to deal with stress and difficult emotions they will have a much more positive experience while involved in treatment. Individuals may be more accepting of cognitive behavioral therapy if they feel they are truly dedicated to the interventions. As an individual is progressing through cognitive behavioral therapy they should be asked how the treatment makes them feel and if the treatment is helpful. This is very important because it gives the individual the time to express whether or not the specific treatment is beneficial for them. If the individual feels the treatment is not helpful steps must be taken to improve it so the client can keep working on their goals. Although the focus of cognitive behavioral therapy is to change the negative behaviors and thoughts the individual is displaying, the person should also be treated as well. As an individual is progressing through treatment, psychologists and counselors should ask how the client is feeling about this specific treatment (D. Donohue, personal communication, October 31, 2013). If the individual can tell that the counselors and psychologists have a true interest in them the individual will be much more involved in the treatment. By feeling involved, the client will be more inclined to stay in the treatment. This is positive because the longer the individual stays in treatment, the greater their chances of success (D. Donohue, personal communication, October 31, 2013). As the individual changes drinking behaviors and coping mechanisms to more positive aspects they must also mend family relationships. Counseling treatment gives alcoholics the chance to focus on their emotions, thoughts and addictions from an internal standpoint. According to Dare and Derigne (2010) individuals go

EFFECTS AND TREATMENT through stages related to their addiction in alcohol abuse. These stages are part of the transtheoretical model. These stages include: pre- contemplation, contemplation, determination, action and maintenance. Individuals in the pre-contemplation stage do not believe they need to change their substance abuse habits (Dare et al., 2010). These individuals do not see any negatives to their drinking behaviors. This stage brings no differences in thoughts or actions in

regards to drinking. The next stage, contemplation allows the individual to think about changing their habits with alcohol but they do not modify the behavior. This may be the stage of change where family members notice a problem with their loved ones drinking. The determination stage allows the individual to start thinking of a plan to change; they realize there is an issue with their drinking that needs to be addressed. The fourth stage: action is where the individual puts their plan into use. Individuals receiving cognitive behavioral therapy are involved in the action stage. The individual involved in cognitive behavioral therapy will take the new skills they have learned and make it part of their lives and daily routines. They will not drink to escape or deal with problems. This is the final stage of addiction in the transtheoritical model (Dare et al., 2010). Counselors must understand that individuals will go through each stage of the transtheoretical model when they are ready and cannot be forced to change. Therapists must be aware of which stage of addiction a client is in (D. Berarducci, personal communication, October 31, 2013). An effective counselor will know which concepts and types of therapy will work for the specific client as well as knowing their personal strengths as a counselor. D. Berarducci also states that one of the biggest indicators of success for a client in therapeutic treatment is the rapport between the client and counselor (personal communication, October 31, 2013). This associates with the earlier psychological statement that clients will be more inclined to stay in

EFFECTS AND TREATMENT treatment if they feel they are truly part of the solution. If an individual feels they have a strong, professional, helpful relationship with their counselor they will be more inclined to stay in therapy. Individuals will continue to receive exposure of positive ways of change in behaviors

and thoughts regarding alcohol abuse. It is important for individuals who abuse alcohol to stay in therapy and for the professional individual to ask the client how therapy is working for them. D. Berarducci communicated that the individual should express if they are progressing negatively or positively through any therapy received, whether psychological or therapeutic (personal communication, October 31, 2013). During a therapeutic session clients may express that they feel proud of themselves by staying sober or attaining personal goals to reduce drinking. A client may also express feelings of negativity that they are struggling to stay sober and reach their goals. When either of these situations arise, the professional might remind the individual of their successes in receiving treatment for their alcohol abuse. The client should be encouraged to be aware of their personal feelings and struggles. This action of encouragement is positive as well as conducive to their growth and positivity (D. Berarducci, personal communication, October 31, 2013). As the individual receives treatment, remains active and positive in personal therapy they can also work on the issues with their family due to alcohol abuse. According to McCrady (2012) alcohol abuse can be seen through the eyes of a marriage and family counselor as a family disorder. When one person in a relationship abuses alcohol there is a risk of physical abuse and a much higher rate of divorce, more than four times that of the general population (McCrady, 2012, p. 514). The spouse not abusing alcohol also may suffer from anxiety or other psychophysiological symptoms resulting from this family disorder. The spouse may become stressed because of the negative actions of their loved one. They may

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also become worried for their children and their personal well-being. All of these negative family dynamics are reasons for an individual to discontinue alcohol use. Family members of the alcoholic are usually the first to notice problems related to alcohol use in the individual. They are also the group that is involved in the initiation, resolution, and maintenance of change in those with alcoholism (McCrady, 2012, p. 515). Alcohol behavioral couple therapy is a type of counseling treatment to help the family unit as well as to help the client refrain from alcohol abuse. During this treatment the family learns to work with the individual and encourage their positive change. Alcohol behavior couple therapy helps clients and families by teaching the individuals coping skills and to change interactions between the couple to more positive ones (McCrady, 2012). The significant others of the clients are taught behaviors that will help the client to maintain positive changes in drinking behavior and to lessen behaviors that may pressure the client to return to drinking. It is important that the alcoholic change their thoughts and behaviors towards alcohol but it is also important for the family to be encouraging towards their loved one. This type of therapy focuses on more than just the client changing their thoughts and behaviors. The clients family environment is also changed to become more positive and conducive towards their cessation of alcohol abuse. This change in the family is a positive one, it will allow for the individual to flourish in their treatment and to feel more positive about their family dynamic. This type of therapy allows changes to happen within the relationship of the couple. Negative attitudes and actions are relearned and are structured as positive for both the alcoholic and significant other. For the individual, this alcohol behavior couple therapy helps to stop the abuse of alcohol, help the motivation of change, develop and improve thoughts, behaviors and coping skills to stay away from drinking (McCrady, 2012). This treatment helps the partner of

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the alcoholic by changing responses to their partners drinking and staying sober. The partner is also taught to decrease behaviors that make the client want to drink (McCrady, 2012). This could mean communications between the couple must be improved. The partner also learns how to be positive towards the client and to not stress over insignificant negatives within the relationship. This action will continue to encourage the alcoholic to stay on the path of treatment. Families can be seen as the cause of the alcohol addiction as well as the maintenance of the abuse (Schafer, 2011). Alcoholism is a disease that affects the whole family unit. The abuse of alcohol within a family influences behaviors between members. It can also cause an imbalance in roles of power (Schafer, 2011). When the individual has been drinking they may start arguments with their significant other. The spouse may learn to fear or resent these arguments and will learn to leave the house when they know their loved one has been drinking. The children in the family learn that they do not like to be around their mother or father when they have been drinking. The children will avoid this specific parent when they have been drinking because they do not like the way they act. If the individual feels that their family is abandoning them they will continue to drink to cope with this loss. If these behaviors keep occurring between family members everyone will be negatively affected. When alcohol abuse is involved in a family, the roles of each family member can change. Individuals that abuse alcohol are unable to have relationships that function properly (Schafer, 2011). The children, when faced with an alcoholic parent to care for them may have to learn to care for themselves. The children may have come to learn that they cannot depend on that specific parent and will care for themselves. The alcoholic parent may forget to pick up the children from school. The children will learn to worry about themselves. The children may also

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feel they do not need the alcoholic parent in their life. The individual may feel like the children are not respecting them as a parent. The alcoholic behaviors of the parent have disrupted the roles the children have to take on in the family. Alcoholism causes issues in a family and the alcoholism can be maintained and promoted within the family (Schafer, 2011). Alcoholism tends to occur in the same family and may continue throughout that family. When one individual has been diagnosed with alcoholism they may have a previous family member with the same disease. First-degree relatives of the individual, such as, siblings and children are three to five times more likely to develop alcoholism than the general population (Schafer, 2011, p. 143). If the children do not learn proper coping mechanisms for life stressors they may use alcohol. The cycle of disruption will occur throughout their new family. Although, alcoholism may seem like it is only affecting one person it really does influence a whole family. As the family unit continues on this path of dysfunction the alcoholic individual may feel very unhappy with himself or herself and their positive self-esteem will decline. They may continue to feel negative about their family situation. They may not see the situation changing positively and their self-esteem will continue to drop for this reason (Luhtanen & Crocker, 2005). This lack of self-esteem could possibly make treatment more difficult. The individual may feel they are beyond saving; they may feel they cannot change their behaviors and thoughts. Each individual who abuses alcohol deserves to have the best treatment for them that will benefit them in a positive way. Matching interventions are another form of therapy for individuals to help them to stop drinking. According to Giovazolias and Davis (2005), there is a need for an integrated model of therapy for individuals who abuse alcohol. All individuals will not respond positively to the

EFFECTS AND TREATMENT same treatment that has worked for someone else in the past. Matching interventions use

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multiple perspectives that guide the therapy and are more specific to the type of individual. This will most likely produce a positive change in behavior for the person involved in treatment (Giovazolias et al., 2005). The motivation of the client is important as to what type of therapy they will receive. Individuals who have low self-motivation may benefit from motivational enhancement therapy than cognitive behavioral therapy (Giovazolias et al., 2005). This relates back to the individual wanting to be part of the treatment. If they feel it is not right for them they will be less inclined to stay in that type of treatment. An individual lacking social support may benefit from a type of treatment that shows them how to gain skills to increase that social support (Witkiewitz & Marlatt, 2011). They may have lost their close family connections while abusing alcohol and to make a positive step in treatment they must learn how to reincorporate loved ones into their lives. Counselors and psychologists should always use a form of treatment that will be helpful for the client and the goals they wish to attain. In conclusion, alcoholism affects the user as well as the people around them. Alcohol abuse may be a way for the individual to escape from the troubles they face in life. The family unit is negatively impacted due to the abuse of alcohol and family relationships are changed, the relationships must be rebuilt as the individual receives treatment. Both psychological treatments as well as counseling treatments help the individual who abuses alcohol. Cognitive behavioral therapy helps the individual by focusing on their thoughts and behaviors regarding alcohol use. They learn how to cope in a more effective and non-damaging manner, while developing positive thoughts and behaviors for their new lifestyle. Individuals can change their behaviors and thoughts when it comes to habits that are negative for their lives. People can turn negative

EFFECTS AND TREATMENT thoughts and behaviors into positive reminders for a more successful life. From a counseling

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perspective, couples must find ways to work together for treatment to be successful. Therapeutic treatment lends a personal aspect to the care of alcohol abuse. Individuals must feel a sense of encouragement and positivity from the counselor to really let the treatment begin and for it to be beneficial.

EFFECTS AND TREATMENT References

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