ol dependence (alcoholism) is a health disorder that results from many years of repeating patterns of excessive drinking. The development of addiction is influenced by biological factors (including genetic predisposition), psychological predispositions and social factors. Progressive alcohol addiction deteriorates the psychosocial functioning of the patient, significantly impedes the performance of tasks related to social roles (in the family, at work), and is the cause of many health problems. Drinking more quickly in adolescence may lead to the development of alcohol dependence.

Alcohol dependence may be a primary problem, but it is often a problem secondary to the previously existing mental and behavioral disorders such as: personality disorders, neurotic (anxiety) disorders, depressive disorders, bipolar disorder, psychotic disorders, ADHD.

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Conversely, the above-mentioned clinical syndromes may develop as a consequence of chronic and excessive alcohol use.

Due to the complex clinical picture of problems resulting from alcohol addiction, it requires comprehensive, phased and individualized treatment, both psychotherapeutic and pharmacological.

Motivating people to start treatment

At the beginning, it is difficult for a person with alcohol and / or other psychoactive substance addiction to admit to themselves and to others that they are addicted. The psychological mechanisms of addiction make it impossible to realistically assess the problem. 

Most often, in the initial phase of motivating to take up treatment, there is a defense mechanism such as denying the problem, minimizing, rationalizing, giving intellectual reasons for drinking, blaming others for drinking alcohol, etc. On the other hand, there is fear and thinking that excessive drinking is a problem. This is the period where you can use this emerging ambivalence and increase the motivation to contact a specialist in addiction psychotherapy, a psychiatrist or psychologist.

Treatment of alcohol dependence is divided into stages:

Diagnostic stage – consultation with an addiction therapy specialist and a psychiatrist:

a.establishing contact,

  1. recognizing the problem,
  2. determining readiness to change the pattern of alcohol use – abstinence or reducing drinking,
  3. diagnosis of alcohol addiction and / or coexisting mental disorders and the degree of its advancement,
  4. if necessary, a psychological examination identifying real difficulties in the area of ​​cognitive functions (thinking, concentration, memory, etc.) and personality,
  5. planning therapeutic interactions,
  6. initiation of appropriate pharmacotherapy,
  7. determining the conditions of therapeutic cooperation and strengthening the motivation to change.

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1. Forms of therapy:

a.individual psychotherapy,

  1. group psychotherapy,
  2. pharmacotherapy (supporting the therapy of alcoholism and / or treating coexisting mental and behavioral disorders),
  3. couple therapy (complementary to addiction psychotherapy).

2. Goals of treatment:

a.stabilization of abstinence or significant reduction of alcohol consumption,

  1. overall improvement of mental and physical health,
  2. broadening the insight into the emotional, cognitive and interpersonal response patterns that support addiction,
  3. introducing changes to psychosocial functioning.

3. Therapy phases:

  1. Preliminary stage:

therapeutic work on the possibility of withdrawing from alcohol use or its significant reduction (psychotherapy, pharmacotherapy),

strengthening the motivation to continue treatment,

strengthening the ability to cope with alcohol craving and extending periods of complete abstinence from alcohol.

  1. Basic stage:
  • work on recognizing your addiction, accepting the health problem and recognizing the limitations resulting from it,
  • better understanding of one’s functioning in the context of psychological mechanisms of addiction,
  • providing new psychosocial skills that help to better cope with everyday stress,
  • acquiring new skills in dealing with tension, e.g. learning relaxation skills,
  • recognition and therapeutic work on changing addictive behaviors,
  • solving personal problems underlying addiction,
  • change of lifestyle to pro-health,
  • treatment of comorbid mental and behavioral disorders (psychotherapy, pharmacotherapy).
  1. Advanced stage
  • Continue working on broadening your understanding of yourself and your functioning in relation to others,
  • further strengthening of life skills and self-efficacy,
  • analysis of serious emotional problems arising from the life story before the development of addiction,
  • work on personality schemas, etc.

 

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