|Narcissistic Clients Future of Psychotherapy Alan Sroufe Men in Therapy Attachment Theory Ethics Linda Bacon The Future of Psychotherapy Clinical Excellence William Doherty Challenging Cases Mind/Body Wendy Behary Anxiety Gender Issues Mary Jo Barrett Symposium 2012 Community of Excellence Diets Clinical Mastery Couples Therapy Great Attachment Debate Mindfulness Etienne Wenger Brain Science Trauma Attachment CE Comments David Schnarch Couples|
|Clinicians Digest Jan/Feb 2008 - Page 5|
Different Alcoholics, Different Treatments
As the idea that 12-step, total abstinence is the one best treatment and goal for alcohol dependence (AD) fades, it's become important to think about different kinds of people with alcohol problems, rather than seeing them as a single, monolithic group. Now for the first time, a national survey based on a study of 1,484 Americans, led by Howard Moss of the National Institute on Alcohol Abuse and Alcoholism and reported in the January issue of Drug and Alcohol Dependence, describes a typology of individuals with AD, which may help target treatments.
The largest and least severe subtype, Young Adults, who averages 24 years of age and represents 31.5 percent of those with AD, though only 8.5 percent of them have ever sought treatment. They drink on fewer days than the other groups, but are the most likely to binge. This subtype generally hasn't yet run into financial, social, or legal problems from drinking. Some of them straighten out, often without professional help, while others move into one of the more severe subtypes.
The next two groups are called Functional and Interfamilial. Including individuals in their late thirties to early forties, both groups have steady jobs, but they drink more often than Young Adults and are near or just over the brink of getting in serious trouble from drinking. Those in the Functional group still believe they can manage their lives: they have the highest income of all the subtypes and only 17 percent have sought help for drinking. Those in the Interfamilial group, while still holding down jobs, are in deeper waters and have begun to realize it. They're more likely than Functionals to have family histories of AD, to suffer from major depressive, obsessive-compulsive, bipolar or anxiety disorders, and to use other substances in addition to alcohol. Some 27 percent of the Interfamilial group has sought treatment.