Online Alcohol Treatment: Counselling & Therapy
Online Counselling & Therapy For Alcohol
A Guide To Online Alcohol Counselling
There are many different types of therapy available. Some counsellors blend a variety of approaches in their work, while others use standard practices and draw from only one or two styles of counselling.
There are various evidence-based modalities that help people overcome their alcohol misuse and regain control of their lives. These include psychotherapy, standard one-to-one counselling and holistic or integrative therapies such as yoga, mindfulness or art therapy.
We’ll focus on talking therapies here, as these are the most common therapies that clients begin with to overcome their alcohol misuse. Naturally, yoga and art therapy can’t really be classed as talking therapies.
Talking therapies are usually broken into psychotherapy, where people deal with long-term issues that perhaps have been around a while, such as alcohol misuse, chronic anxiety, depression and trauma. And person-centred counselling helps people resolve short-term or current issues such as bereavement or where there is no history to it or root in the past.
Psychotherapy is usually the fundamental approach to alcohol addiction treatment as it allows people to change feelings, thoughts and behaviours in order to stop drinking alcohol and stay stopped. By engaging in open and honest conversations with a trained psychologist or psychotherapist people can explore their challenges, experiences and emotions related to their alcohol use. Talking therapy can take place in various settings and modes, including one-on-one sessions, group settings, in rehabs, online and even involve family members.
During psychotherapy, the aim is to understand the underlying causes of alcohol addiction – which are usually formed historically but could arise through life events – and help clients develop strategies to manage cravings, stay motivated and achieve sobriety goals.
The therapist-client relationship is built on trust, openness and confidentiality, allowing for a safe space to address deep-rooted issues.
There are multiple approaches to psychotherapy, including psychoanalysis, behavioural therapy, cognitive therapy and integrative or holistic therapy. Each approach offers unique insights and techniques to support people on their journey to recovery.
Person-centred therapies are usually not classed as psychotherapy and more behavioural therapies, however, approaches such as Motivational Interviewing can have exceptional outcomes in treating alcohol addiction, as it gives people the drive to change behaviours and, in turn, changes their emotions.
Four Effective Alcohol Therapies
Cognitive Behavioural Therapy (CBT)
Rewiring Negative Thoughts
Cognitive Behavioural Therapy (CBT) is a proven and effective method for addressing alcohol use disorder. This approach identifies negative thoughts and behaviours and replaces them with positive alternatives. By challenging harmful beliefs, confronting fears and developing strategies to stop drinking, people can gain control over their addictive behaviours.
CBT sessions typically involve conversations between the patient and therapist. Through cognitive restructuring, people learn to notice and replace unhelpful thought patterns and develop coping skills to manage cravings. By identifying triggers and engaging in positive activities, people can fill the void left by alcohol and create a healthier lifestyle.
Dialectical Behavioural Therapy (DBT)
Finding Resilience and Regulation
Dialectical Behavioural Therapy (DBT) is another evidence-based approach to alcohol addiction therapy. Initially designed to treat borderline personality disorder, DBT has shown effectiveness in addressing substance abuse disorders including alcoholism.
DBT operates under the principle that everything is connected, and change can be achieved by accepting and synthesising opposing elements. DBT sessions focus on living in the present, managing emotions and distress, and promoting honest communication. By finding emotional balance and embracing positive change, people can overcome alcohol addiction.
DBT incorporates four main strategies taught by clinicians to clients:
- Core Mindfulness: Cultivating present-moment awareness
- Distress Tolerance: Building skills to handle distressing situations
- Interpersonal Effectiveness: Improving communication and relationship skills
- Emotion Regulation: Developing techniques to manage emotions effectively
Motivational Interviewing (MI) is a counselling method aimed at encouraging people to overcome ambivalence, set goals for self-improvement and maintain motivation for change. MI is particularly effective in treating alcohol misuse as it helps people regain a sense of empowerment and commitment to recovery.
During a motivational interview, therapists work collaboratively with clients to explore their motivations for change and the positive and negative aspects of their alcohol use. By resolving ambivalence and enhancing self-efficacy, we can gain the confidence and drive to make meaningful changes to their drinking.
MI is often a brief intervention, consisting of one to four sessions. The counsellor employs empathetic and supportive styles, rolling with resistance and guiding clients towards greater self-awareness and willingness to change.
Support and Connection
The 12-Step approach involves participating in 12-step support groups, including Alcoholics Anonymous (AA). These groups provide a supportive community where members can openly share their struggles with alcohol addiction. The 12-Step Program emphasises acceptance, abstinence and growth as essential steps toward recovery.
In 12-Step therapy, people work with a therapist to guide them through the 12 steps within each session. Therapy sessions focus on exploring the impact of alcoholism, developing coping skills, honesty, resilience and connection. By actively participating in 12-step meetings and incorporating the principles of the program into their lives people can find support and accountability on their journey to sobriety.
Effectiveness of Alcohol Addiction Therapy
Treatment for alcohol addiction is a dynamic and ongoing process. While therapy offers valuable tools and support, people may – and do – experience setbacks and relapses along the way. It’s good to view relapse as a temporary setback rather than a failure, using it as an opportunity to learn and improve coping skills.
Research has shown that treatment for alcohol addiction through various therapy modalities and support groups like Alcoholics Anonymous is highly effective for most people.
Our Recommended Recovery Pathway
We’ve helped hundreds of people overcome alcohol addiction. Usually, this is with a combination of medical treatments, counselling & therapy and support groups.
Detox Today’s recommended recovery plan is normally a 3-stage process:
- medical alcohol detox to rid the body of alcohol safely and comfortably
- psychological therapies to quickly deal with any serious emotions and behaviours
- mutual support groups for continued sobriety
It’s our recommended recovery advice and has worked for many people we’ve treated as well as countless others around the world who follow it. The exact nature or process of each of these, whether it’s done in person as an outpatient, remotely online or in a rehab clinic, is entirely up to the person. We can advise on the best path for you.
Recovery is a personal journey and seeking professional help is an important first step towards a healthier and alcohol-free future.
Cognitive Behavioural Therapy (CBT)
Cognitive Behavioural Therapy (CBT) is a widely available and effective form of psychological treatment or psychotherapy that was developed by Doctor Aaron T. Beck, an American psychiatrist in the 1960s in the US.
What is Cognitive Behavioural Therapy?
It can help people overcome various mental health challenges including alcohol addiction. Cognitive Behavioural Therapy (CBT) is a highly effective form of treatment for alcoholism. The therapy focuses on addressing problematic thoughts and behaviours to help people overcome any negative feelings that might cause and fueld their addiction and helps to achieve long-term recovery.
It’ss based on the principle that our thoughts, feelings and behaviours are interconnected and influence each other. CBT aims to identify and change negative or distorted thinking patterns and behaviours that contribute to psychological problems including addiction.
The core principles of CBT are:
Thoughts influence emotions and behaviours
CBT suggests that our thoughts can shape our emotions and behaviours. Negative or irrational thoughts can lead to negative emotions and unhealthy behaviours such as excessive drinking or substance abuse.
Identifying and challenging cognitive distortions
CBT helps people identify and challenge their “cognitive distortions”, which are irrational or faulty thoughts. By examining the evidence and testing the truth/validity of these thoughts, therapists can help you can replace them with more realistic and positive beliefs.
Learning coping skills and behavioural changes
CBT teaches us new coping skills and healthier behaviours to replace “maladaptive” ones. This includes developing effective problem-solving strategies, managing cravings and improving communication skills.
How Does CBT Work in Alcohol Addiction Treatment?
In alcohol treatment, CBT focuses on helping to understand the relationship between their thoughts, feelings and drinking behaviours. By identifying the triggers and underlying beliefs that contribute to their alcohol use, clients can develop healthier coping mechanisms and reduce the risk of relapse.
One of the key techniques used in CBT for alcohol treatment is cognitive restructuring. This involves identifying and challenging negative or distorted thoughts related to using alcohol. By examining the evidence and considering alternative perspectives, you can replace these negative thoughts with more positive and realistic ones.
For example, someone struggling with alcoholism may have the belief that they need alcohol to cope with stress or social situations. Through cognitive restructuring, they can challenge this belief by recognising healthier coping mechanisms, such as engaging in relaxation techniques or seeking support from friends and family.
In addition to cognitive restructuring, CBT for alcohol treatment also uses behavioural strategies to promote lasting change. These strategies focus on modifying behaviours that contribute to alcohol use and developing healthier alternatives.
Some common strategies used in CBT for alcohol treatment include:
Trigger identification and avoidance
Clients learn to identify the situations, people or emotions that trigger their desire to drink. By avoiding these triggers or developing coping mechanisms, they can reduce the risk of relapse.
CBT teaches practical skills to manage cravings, cope with stress and solve problems effectively. This can include relaxation techniques, assertiveness training, and communication skills.
Goal setting and self-monitoring
Setting specific goals and tracking progress can help us stay motivated and accountable in their recovery. Self-monitoring involves keeping a record of alcohol consumption, triggers,and emotions to gain insight into patterns and make informed decisions.
Is CBT Effective in Alcohol Treatment?
Research has consistently shown the effectiveness of CBT in alcohol treatment. Numerous studies have demonstrated that CBT can reduce alcohol consumption, improve treatment outcomes and prevent relapse.
A study published in the Journal of Consulting and Clinical Psychology found that CBT was more effective than other forms of therapy in reducing alcohol consumption and maintaining abstinence. The study also highlighted the importance of incorporating behavioural strategies such as trigger identification and coping skills training in achieving successful outcomes.
Another meta-analysis published in the journal Addiction concluded that CBT was effective in reducing alcohol consumption and improving treatment retention rates. The analysis also highlighted the importance of individualised treatment plans and ongoing support in maximising the benefits of CBT.
How Does CBT Help in Overcoming Drinking?
CBT can help people overcome drinking and achieve long-term recovery by addressing the underlying thoughts, emotions and behaviours associated with alcohol use. CBT equips people with the tools and skills necessary to break free from the cycle of addiction.
Recognising & Challenging Negative Thoughts
One of the key aspects of CBT is helping people understand and challenge their negative thoughts related to boozing. By identifying cognitive distortions, such as black-and-white thinking or catastrophising, people can learn to replace these thoughts with more balanced ones.
For example, someone struggling with alcoholism may have the belief that they are a failure if they can’t quit drinking on their own. Through CBT, they can challenge this belief by recognising that addiction is a complex issue and usually requires professional help and support, as very, very few can do it on their own.
Developing Coping Skills and Relapse Prevention Strategies
The therapy also focuses on developing coping skills and relapse prevention strategies to help clients manage cravings, triggers and high-risk situations. By learning alternative ways to cope with stress, boredom or emotions, people can reduce their reliance on alcohol as a coping mechanism.
Some common coping skills taught in CBT include:
- Relaxation techniques such as deep breathing or progressive muscle relaxation to manage stress and anxiety
- Assertiveness training to improve communication and set boundaries in social situations
- Problem-solving skills to address underlying issues or conflicts that contribute to drinking
Building a Supportive Network
CBT emphasises the importance of building a supportive network to aid in recovery. This can include family, friends, support groups or therapists who can provide encouragement, accountabilit, and guidance throughout the recovery process.
By involving loved ones in the treatment process, people can cultivate a strong support system that reinforces positive behaviours and provides a safety net during challenging times.
How To Get CBT for Alcohol Treatment
If you or someone you know is struggling with alcoholism or excessive drinking, signing up for some CBT sessions for alcohol treatment can be a transformative step towards recovery. CBT offers a structured and evidence-based approach to addressing the underlying thoughts and behaviours that contribute to addiction.
When looking CBT for alcohol treatment, make sure to find a qualified therapist or treatment centre that specialises in addiction and has experience in delivering CBT interventions. A professional can assess your unique needs and develop a personalised treatment plan tailored to your specific goals and circumstances. Speak to us about how CBT can help, our CBT packages and what to look for in a therapist.
Overcoming drinking and achieving lasting recovery is a journey that requires commitment, patience and ongoing support. With the help of CBT, people can develop the necessary skills and strategies to break free from the grip of alcoholism and lead a healthier, more fulfilling life.
Benefits of CBT in Addiction Treatment
Engaging in CBT can offer several benefits that contribute to overall well-being and improved mental health. Here are some key benefits associated with CBT:
CBT is typically a short-term therapy lasting between five to 20 sessions. This makes it more affordable and accessible for many people.
Research suggests that CBT can lead to lasting improvements, reducing the chances of relapse compared to medication-only treatment for addiciton, anxiety and depression.
CBT can be delivered in various formats including in-person sessions, group therapy (rehab), online therapy and phone-based. This allows people to choose the format that best suits their needs and preferences to tie-in with their other commitments.
CBT equips us with practical coping skills that can be applied to everyday life. These skills empower people to manage their difficulties independently.
Active Role in Healing
CBT encourages people to be active participants in their own healing process. By learning and applying coping skills, people gain a sense of empowerment and control over their mental health.
CBT can be used as a standalone treatment or in combination with medication, depending on the person’s needs and preferences. Consult with a qualified therapist or healthcare professional to determine the most appropriate treatment plan.
What to Expect in CBT Sessions
Attending CBT session can be overwhelming at first but knowing what to expect can help ease any anxiety or uncertainty. Here is a general outline of what typically happens in CBT sessions:
The therapist will conduct an initial assessment to understand symptoms, emotions and difficulties. They may also inquire about any physical signs of distress.
The therapist and client will discuss goals for therapy and what they hope to achieve. This helps guide the treatment process and ensures that therapy aligns with client needs and aspirations.
The therapist will explain the therapy policies including confidentiality, session length and the recommended number of sessions.
CBT is a collaborative process where cliebt and therapist work together to develop an understanding of the challenges and develop a treatment strategy.
Homework assignments are a crucial part of CBT allowing people to practice and apply the skills learned in therapy to real-life situations. The therapist may assign specific exercises or tasks for completion between sessions.
Client and therapist maintain open communication. Clients should feel free to ask questions, express any concerns or difficulties and discuss progress or any challenges they may be facing.
Finding the right therapist is critical for a successful therapeutic journey. If clients don’t feel comfortable or connected with their therapist, it’s perfectly acceptable to seek alternative options until they find a good fit.
CBT & Alcohol Dependence Summary
Cognitive Behavioural Therapy (CBT) is a highly effective psychological treatment that can help people with alcohol issues overcome a wide range of challenges. By focusing on changing negative thought patterns and behaviours, CBT empowers people to take an active role in their healing process to overcome alohol addiction. With its evidence-based approach and diverse range of techniques, CBT offers the opportunity to develop practical skills to manage difficulties effectively. If you are considering therapy, CBT may be a valuable option to explore with a qualified therapist.
CBT References & Sources
Dialectical Behaviour Therapy (DBT)
What is Dialectical Behaviour Therapy (DBT)?
Dialectical behaviour Therapy (DBT) offers a unique and effective approach to treating alcoholism by targeting the core issues that drive addictive behaviours.
DBT is a type of psychotherapy that was initially developed to treat borderline personality disorder. It has since been adapted to address a wide range of mental health conditions, including addiction. DBT combines elements of cognitive behavioural therapy (CBT) with concepts from mindfulness practices to help us develop skills for emotion regulation, distress tolerance, interpersonal effectiveness, and mindfulness.
Does DBT Work for Alcoholism?
The word “dialectical” means how two things, that are seemingly opposite or contradictory, could both exist and be true at the same time. For example, accepting yourself and changing your behaviour might feel contradictory. Or, you may love someone but also at the same time not be able to spend any time with them because of resentment. But DBT teaches that it’s possible for you to accept both these things and that by understanding dialectics, we can heal and overcome turmoil.
DBT addresses the underlying issues that contribute to alcoholism by teaching people healthier ways to cope with stress, regulate their emotions and improve relationships. By targeting these areas, DBT helps us develop the skills necessary to manage addiction and maintain long-term recovery. The therapy can be summed up in helping people in two main ways: acceptance and change.
The key components of DBT that make it effective for treating alcoholism:
Mindfulness is a core skill in DBT that involves observing self without judgements and the surrounding environment. By practising mindfulness, clients become more aware of the physical and mental triggers that lead to alcohol cravings and can develop strategies to cope with them effectively. Mindfulness also helps clients stay in the present, reduce impulsive behaviours and promotes healthier decision making.
Distress tolerance skills are important for those struggling with alcoholism as they teach us how to endure painful emotions and situations without resorting to alcohol. DBT helps develop healthier ways to cope with distressing situations, accept the things they cannot change and move forward in a positive direction.
Emotion regulation skills enable people to identify and manage intense emotions that contribute to alcohol use. Through DBT people learn to understand when their emotions are unproductive and develop strategies to change them into more positive and adaptive emotions. By improving their ability to regulate emotions, clients can reduce their reliance on alcohol as a coping mechanism.
DBT helps to improve interpersonal skills which are essential for maintaining healthy relationships and support systems during recovery. Through DBT people learn effective communication techniques, assertiveness and how to set boundaries. These skills enable clients to develop healthier relationships and seek support from others instead of turning to alcohol.
The Benefits of DBT In Addiction Recovery
DBT offers numerous benefits for those struggling with alcoholism. Here are some of the key advantages of using DBT as a treatment approach:
DBT addresses the underlying emotional and behavioural factors that contribute to alcoholism providing a more comprehensive and holistic treatment approach, compared to other methods that focus solely on psychological abstinence.
DBT equips people with the skills to understand and manage intense emotions, thereby reducing the likelihood of turning to alcohol as a means of escape or coping.
Through mindfulness practices, people gain a deeper understanding of their thoughts, emotions, and behaviours. This self-awareness allows them to identify potential triggers for alcohol use and make conscious choices to avoid relapse.
By teaching people how to tolerate distressing situations without resorting to alcohol, DBT empowers people to face challenges head-on and develop healthier coping mechanisms.
Improved Interpersonal Relationships
DBT teaches how to develop and maintain healthy relationships. By improving communication skills, setting boundaries, and resolving conflicts, people can establish supportive social networks that promote sobriety and overall well-being.
Lasting Long-Term Recovery
DBT is designed to provide people with the necessary tools and skills to maintain long-term recovery from alcoholism. By addressing underlying issues and building resilience correctly the first time, contributes to a better mental health, awareness and coping mechanism to overcome any future challenges and maintain sobriety.
The Four Stages of DBT
DBT is typically divided into four stages of treatment:
Stage 1: Addressing Life-Threatening Behaviours
During Stage 1, the primary focus is on addressing any life-threatening behaviours, such as self-harm or suicidal tendencies, overdose and serious alcohol and drug misuse. The therapist works closely with the individual to establish safety and stabilisation, ensuring that immediate risks are effectively managed. Ideally, this would be alcohol abstinence as soon as possible, if the client is not already sober.
Stage 2: Enhancing Quality of Life
In Stage 2, the focus shifts to improving the individual’s quality of life by addressing issues such as emotional regulation, distress tolerance and interpersonal effectiveness. This stage aims to equip people with the necessary skills to navigate life’s challenges more effectively and reduce the impact of problematic behaviours.
Stage 3: Addressing Trauma and Self-Esteem
Stage 3 involves addressing underlying trauma, improving self-esteem and confidence, and further developing interpersonal skills. This stage aims to help us heal from past traumas, build a positive self-image, see that they are worthy of living a happy, alcohol-free life and fix or establish healthy relationships.
Stage 4: Finding Meaning and Purpose
The final stage of DBT focuses on helping clients find meaning and purpose in their lives. This includes setting and pursuing goals, cultivating a sense of fulfilment and maintaining the progress made throughout the previous stages.
Getting Started with DBT
For those considering DBT as a form of therapy, please find a qualified mental health professional who is trained in DBT. At Detox Today, we have a number of therapists and practitioners who can offer it online or in person.
Once you find the counsellor you think is a good fit, an initial evaluation usually takes place. This is where the therapist will assess your specific needs and determine if DBT is the right fit for you. If DBT is recommended, you may be expected to participate in both individual therapy sessions and some group skills training sessions (in person or online), by agreement with the therapist, although group sessions are not always ideal for everyone. Individual sessions typically last an hour, while group sessions may range from one hour to two hours. Homework assignments and skill practice between sessions are integral parts of the DBT treatment process.
Modes of DBT Therapy
Individual therapy sessions in DBT provide a safe and confidential space for people to explore their thoughts, feelings and behaviours related to alcoholism. Therapists work collaboratively with clients to set goals, develop personalised treatment plans and provide guidance and support throughout the recovery process.
Group therapy can be an integral part of DBT. In a group setting, people can learn from others who are facing similar challenges. Group therapy sessions focus on teaching DBT skills, fostering peer support and providing a sense of community. Participants share experiences, discuss challenges, and celebrate successes, which creates a supportive environment for recovery.
Phone and Online Coaching
DBT also offers phone coaching as a valuable resource between therapy sessions. Clients can usually reach out to their therapists for guidance and support during difficult or triggering situations. Phone coaching helps us apply DBT skills in real-time and reinforces the learning process.
Summary of DBT For Alcoholism
Dialectical Behaviour Therapy (DBT) offers a unique and effective approach to overcoming alcoholism by addressing the underlying emotional and behavioural factors that contribute to addiction. By incorporating mindfulness, distress tolerance, emotion regulation and interpersonal skills, this therapy provides people with the tools they need to manage cravings, cope with distressing situations, regulate their emotions and build healthy relationships – all necessary to overcome alcohol addiction. Although it’s not as well known as some other therapies, many rehab clinics are adopting it as a main treatment. It’s worth exploring DBT as a treatment option to support long-term recovery. Remember, seeking the guidance of a trained therapist is essential for personalised and effective DBT treatment.
DBT References & Sources
Motivational Interviewing (MI)
Motivational Interviewing (MI) is an evidence-based approach to behaviour change that is widely recommended in various fields including healthcare, addiction treatment and mental health. It’s a collaborative and goal-oriented style of communication and aims to strengthen motivation and commitment to a specific goal by exploring reasons for change within an atmosphere of acceptance and compassion.
What is Motivational Interviewing?
Motivational Interviewing is defined by Miller and Rollnick as a “guiding style of communication that sits between following (good listening) and directing (giving advice)”. It’s designed to empower people to change. It does this by helping clients make their own meaning, importance and capacity for change. MI, from the therapist view, is based on a respectful way of being with people that helps facilitate the natural process of change while preserving the autonomy of the client – they discover everything to help themselves.
Key qualities of Motivational Interviewing include:
- A guiding style of communication
- Empowerment of people to change
- Respectful and curious approach
- Honouring client autonomy
It’s important to note that MI is not about imposing change or giving unsolicited advice. Instead, it requires the therapist to engage with the client as an equal partner, actively listening and reflecting the client’s thoughts and motivations. MI is a skill that takes time, practice and self-awareness for the therapist to master.
The Four Core Elements of Motivational Interviewing
Motivational Interviewing is built on four core elements that guide the therapeutic process:
MI is a collaborative process where the therapist and client work together as equal partners. The therapist knows the client is the expert on their own life, while the therapist brings expertise in helping people change.
MI believes that people have the resources and skills necessary for change within themselves. The therapist’s role is to bring forth the client’s priorities, values and wisdom, guiding them to explore their reasons for change and supporting their success.
The MI therapist always adopts a non-judgmental stance, seeking to understand the client’s perspectives and experiences. They express empathy, highlight strengths and respect the client’s right to make informed choices about changing or not changing.
The therapist actively promotes and prioritises the client’s welfare and well-being. They genuinely care about the client’s journey and support them without judgment or personal agenda.
The Stages of Change Model and Motivational Interviewing
The Stages of Change model, proposed by Prochaska and DiClemente, describes the incremental processes we go through when changing a particular behaviour. This model highlights the importance of readiness for change, as well as the presence of motivation, ambivalence, and resistance.
The Stages of Change model consists of five stages:
In this stage, people are not considering change and may be unaware of the need for change. The role of the MI practitioner is to raise doubt and increase the patient’s perception of the risks and problems associated with their current behaviour. Harm reduction strategies may also be provided.
During the contemplation stage, we are actively ambivalent about change. They weigh the pros and cons and may feel stuck between wanting to change and not wanting to change. The MI practitioner works on exploring ambivalence, identifying reasons for change and risks of not changing, and increasing the client’s confidence in their ability to change.
Preparation – Action
In this stage, people are ready to make a change and begin planning and committing to it. The MI practitioner helps the client set clear goals and develop a realistic plan for change. Steps toward change are undertaken during this stage.
Once people have taken action and made changes, the focus shifts to maintaining and sustaining those changes. The MI practitioner helps the client identify and use strategies to prevent relapse and continue practicing the desired behaviour.
Relapse is considered a normal part of the change process and is an opportunity for learning. The MI practitioner helps the client renew the processes of contemplation and action without becoming demoralised or stuck.
The Stages of Change model provides a framework for understanding the progression people go through when changing a behaviour. Motivational Interviewing techniques can be tailored to each stage, helping people move from ambivalence to commitment and action.
Motivational Interviewing & Behaviour Change
Motivational Interviewing has been successfully applied across a wide range of settings, populations and presenting concerns. It has been used in health, corrections, human services, education and various treatment formats (individual, group, online). MI has been effective in addressing many issues incuding alcohol and drug use, smoking cessation, sexual risk behaviours, treatment adherence, medication adherence, substance use, mental health, crimila behaviours and gambling.
Research studies comparing Motivational Interviewing to other evidence-based approaches have shown favourable results. MI has been found to be equivalent to or better than approaches such as cognitive behavioural therapy (CBT) or pharmacotherapy in certain cases. Meta-analyses have consistently shown the effectiveness of MI in decreasing alcohol and drug use in both adults and adolescents.
The compatibility of MI with the values of many disciplines and evidence-based approaches has contributed to its widespread acceptance and applicability. The intuitive appeal and core elements of MI can be readily applied in practice, even as the full framework of MI requires time, practice and skill development. The presence of observable practice behaviours in MI allows therapists to receive clear and objective feedback, enhancing their proficiency in using MI techniques.
The “Spirit” of Motivational Interviewing
At the heart of Motivational Interviewing is its spirit according to Miller and Rollnick, which emphasises collaboration, evocation and honouring patient autonomy. This guides the therapist’s approach and sets the tone for the therapeutic relationship. Without embodying this ethos of MI, the use of MI techniques alone may prove ineffective.
MI promotes a partnership between the therapist and the client. Joint decision-making occurs, and the therapist acknowledges the client’s expertise about themselves. The therapist avoids confrontation and instead works with the client to explore ambivalence, alternatives, and reasons for change.
The therapist’s role is to evoke the client’s motivation for change by eliciting their own reasons and exploring their unique perspective. The therapist actively listens and reflects the client’s thoughts and feelings, guiding them to a deeper understanding of their motivations.
MI respects and honours the client’s autonomy and right to make their own decisions. The therapist understands that the decision to change ultimately rests with the client. The practitioner collaboratively works with the client to increase their confidence in their ability to change (self-efficacy) and supports them throughout their journey.
By embodying the spirit of MI, therapists create a safe and supportive environment that facilitates open and honest conversations about change.
Applying Motivational Interviewing in Practice
Building Motivation to Change
In the initial phase of applying Motivational Interviewing, therapists focus on building motivation to change. This involves employing specific techniques to engage clients and explore their thoughts, feelings, and motivations.
Ask Open-ended Questions
Open-ended questions encourage clients to delve deeper into their experiences, perspectives, and ideas. By eliciting a broad range of responses, therapists gain a better understanding of the client’s values, goals, and motivations for change.
Affirming clients’ strengths, efforts, and past successes helps build their hope and confidence in their ability to change. Affirmations validate and support clients during the change process.
Reflections involve carefully listening to clients and reflecting back their statements in a way that captures the underlying meaning and feeling. Reflections demonstrate empathy, deepen understanding, and encourage personal exploration of motivations for change.
Summarising ensures shared understanding and reinforces key points made by the client. It allows therapists to check in with clients, point out discrepancies between the client’s current situation and future goals, and demonstrate active listening.
By employing these techniques, therapists create a supportive and collaborative environment that encourages clients to explore their motivations for change.
Strengthening Commitment to Change
Once motivation to change has been established, therapists shift their focus to strengthening commitment to change. This involves setting clear goals and developing a change plan with the client.
Therapists can use targeted questions to elicit “change talk” from clients, which refers to statements that express their intention and commitment to change. By exploring the disadvantages of the status quo, the advantages of change, their optimism for change, and their intention to change, therapists help clients understand the discrepancy between their current situation and their desired future.
The therapist should also work on building the client’s confidence in their ability to change, highlighting their strengths and past successes. By using confidence rulers or scales, therapists can assess clients’ confidence levels and help them identify strategies to increase their confidence.
Finally, therapists collaborate with clients to develop a change plan and set realistic goals. This plan considers the client’s motivations, strengths and readiness to change. The therapist respects the client’s autonomy and provides advice or information only with the client’s permission.
MI for Alcohol Treatment
Motivational Interviewing has been particularly effective in the treatment of alcohol addiction. MI techniques can be applied to help us explore their relationship with alcohol, increase their motivation to change and commit to a treatment plan.
In the case of alcohol addiction, MI practitioners can employ the spirit of MI to address ambivalence and resistance. By engaging in open-ended conversations, therapists can help clients reflect on the impact of their drinking on their health, relationships and overall well-being. Affirming clients’ efforts to seek help and change can boost their confidence and self-efficacy.
Through careful listening and reflections, therapists can help clients acknowledge the discrepancies between their current drinking patterns and their desired goals. This process of evoking change talk within, and exploring reasons for change, can empower people to commit to abstain from alcohol.
Therapists can also provide harm reduction strategies and support people in developing coping mechanisms to manage cravings and triggers. The use of MI techniques in alcohol addiction treatment allows for a compassionate and non-judgmental approach that encourages clients to take ownership of their recovery journey, often begining the road to sobriety.
Motivational Interviewing Summary
Motivational Interviewing is a powerful approach to behaviour change that empowers people to explore their motivations and commit to making positive changes in their lives. By embodying the spirit of MI and employing specific techniques, therapists can build motivation and strengthen commitment to change.
MI has proven effective in various domains, including alcohol addiction. Its wide applicability and compatibility with other evidence-based approaches make it a valuable tool for counsellors in rehabs, detox clinics and in outpatient recovery modes.
As therapists continue to refine their skills in Motivational Interviewing, they can help people overcome ambivalence, increase their self-efficacy, and achieve lasting behavior change – exactly what people with alcohol addiction need. With its collaborative and compassionate approach, MI holds great potential in facilitating positive transformations in the lives of those seeking to stop drinking alcohol.
12-step counselling has emerged as an extremely successful path for people seeking recovery. These programs, rooted in the principles of Alcoholics Anonymous (AA), provide a structured framework that promotes self-reflection, personal growth and the support of a community of people abstinent or in striving for recovery.
Understanding The 12-Steps
12-step programs, initially established by Bill Wilson and Dr Bob Smith in 1935, were primarily designed to address alcohol addiction. They are often referred to as the “AA Programme”. Since its inception, the steps programmes have expanded to encompass various forms of addiction, including drug misuse, compulsive overeating, gambling and addictive shopping. They serve as a lifeline for those struggling with addiction, offering a supportive community and a structured approach to overcoming destructive patterns of thinking and behaviour.
The cornerstone of 12-step programs lies in their adherence to a set of steps (twelve of them) that guide people through their recovery journey. Each program tailors these steps to address the specific addiction it focuses on. Participants work through the steps in order, attending meetings to receive support and encouragement.
It’s often misunderstood to be a religious or pious programme of recovery, which it isn’t, due to some of the wording in the original book of Alcoholics Anonymous. It is still used today more or less in its original form.
While the book does mention God, higher powers and spirituality, it is important to note that these programs are open to people of all beliefs, as well as atheists and agnostics, who are encouraged to simply be willing to believe that something outside of them can help keep them sober. Many people simply use Alcoholics Anonymous as an organisation, and the power of recovery that lies withing the group and its members, as a form of a “higher power” and therefore outside help. The concept of 12-steps being that as stand-alone humans, we do not have the capability or capacity to stay sober on our own, that we need external help. And, who doesn’t need help at any point in their lives? Especially when it comes to dealing with alcohol addiction. Most people who have recovered from alcohol addiction would testify that it’s almost impossible for them to stop drinking and stay stopped on their own.
The 12 Step Programme To Sobriety And Freedom
The 12-step approach provides a roadmap for people seeking recovery from alcohol dependence. It takes the form of 12 suggestions that people take, in sequential order, that provides a plan or road map for sobriety. Below is a summary of each step and its significance in the recovery process:
Step One: Admitting Powerlessness and Being Honest With Oneself
The first step acknowledges the powerlessness people feel in the face of their addiction. It also requires them to confront the reality that their lives have become unmanageable. This step serves as a catalyst for change, prompting people to seek help and embark on their journey to recovery.
Step Two: Embracing Hope & Finding The Faith That You Can Get Well
In the second step, people embrace hope and believe that a power greater than themselves can restore them to sanity. This step encourages people to let go of self-reliance and open themselves up to the possibility of healing and transformation.
Step Three: Surrendering to Win. Opening Ourselves To Outside Help
Step three centres around surrendering, as people accept that their lives have become unmanageable and that they need outside help, divine guidance or faith in something other than themselves to deal with alcohol. This surrender marks a significant shift in mindset, allowing people to let go of control and place their trust in a power outside themselves. It’s a commitment to take action and further steps.
Step Four: Soul Searching. Looking At Our Thoughts & Feelings
Step four involves taking what AA calls a “moral inventory”. This is where people explore their past actions and behaviours. This introspection helps them identify patterns, character defects or traits, and unresolved emotional issues that have fuelled their addiction. By facing these aspects of themselves peoplelay the foundation for personal growth, changing mindsets and healing.
Step Five: Sharing the Inventory and Integrity
Step five encourages us to share their personal inventory with another person. This person is usually called a sponsor. They can be counsellors, sober alcoholics or a friend. Usually, it’s a therapist or an AA sponsor who has also completed the 12-steps, are sober and have peace in their lives. This act of confession and vulnerability promotes accountability and fosters a sense of connection. By openly acknowledging their shortcomings, people can begin to heal and move forward. This step and the previous one should not be under-estimated in terms of its potential to change people’s lives for better.
Step Six: Acceptance And Willingness To Change
In the sixth step, we cultivate willingness to let go of their defects of character and harmful behaviours. This breeds an acceptance that everyone has good and bad traits and thoughts, and that we are not bad people. Good people have sometimes behaved badly right? This step really helps people let go of the past. By embracing change, people pave the way for transformation, positive change and a bright future that seemed so out of reach even days or weeks before.
Step Seven: Humbly Asking for Help And Intervention
Step seven involves humbly prepared to let go of any thinking and behaviours that are harmful to ourselves, to remove shortcomings. This step demonstrates the importance of relying on a power beyond oneself for guidance and support, whatever you believe that power to be. By acknowledging limitations and seeking outside help, people open themselves up to profound healing.
Step Eight: Willingness to Set Right Some Wrongs
Step eight focuses on making a list of people the client has crossed swords with – in other words, people they have harmed by their addiction – and being willing to put things right, or at least be willing to. This step encourages us to take responsibility for their actions and strive to repair the damage caused by their addiction. Making amends fosters healing and reconciliation with oneself and others.
Step Nine: Making Direct Amends
In step nine, we actively seek to make direct amends to those they have harmed, except when doing so would cause any further harm to the client or the person they want to make the amends to. This step requires courage, humility and a commitment to personal growth. By making amends, people restore relationships and cultivate a sense of integrity. This allows clients to forgive themselves for everything they have done in the past.
Step Ten: Continued Maintenance
Step ten involves ongoing self-reflection and a commitment to promptly admit when one is wrong. It emphasises the importance of staying vigilant and addressing character defects and harmful behaviours as they arise. This step supports us in maintaining their progress and preventing relapse. By keeping on top of their thoughts and actions, eradicating anything that might cause relapse, people can easily live sober.
Step Eleven: Practicing Calmness and Lowering Stress
Step eleven encourages people to continually grow and look outside themselves for spirituality. It develops a calmness within and allows people to grow emotionally and develop a bigger sense of being. This step fosters a deeper connection to oneself and provides a source of strength and guidance throughout the recovery journey.
Step Twelve: Carrying the Message
The final step involves helping others to get and stay sober. By giving back and helping others on the path to recovery and sharing their experience, strength and hope, clients become sources of inspiration and support for those who are still struggling. This step reinforces the idea that recovery is a lifelong journey and that people can find purpose and fulfilment in helping others to get well from addiction.
The Effectiveness of 12-Step Counselling
Despite some having concerns about the religious undertones of the 12 steps, many people who have recovered in AA are not religious at all. Numerous studies have shown positive outcomes associated with active involvement in such programs regardless of religious beliefs. The sense of community, accountability and support they offer has proven to be invaluable for many people seeking recovery.
Research has indicated that early involvement in 12-step meetings and engagement in recovery activities are associated with improved substance use outcomes, psychosocial well-being, quality of life and reduced healthcare costs. These programs provide us with a safe space to share their experiences, gain insights from others and build a network of support. The power of connection and the shared understanding of fellow participants contribute to the effectiveness of 12-step counselling.
Finding a 12-Step Practitioner
If you or a loved one are considering 12-step counselling, please find a qualified and experienced 12-step therapist of long time sober alcoholic. They are trained to guide people through the steps, provide support and facilitate the recovery process.
Attending Alcoholics Anonymous and undertaking the 12-steps as part of AA is free and widely available. Many inpatient rehab clinics offer the 12-steps – or at least the first three of them depending how long the client has booked in for – as part of their rehab timetable.
In addition, there are therapists who guide people through the AA programme, or 12-steps, as a form of private therapy. Undertaking this route often gives people a structured approach to the programme and also the benefit of having a trained therapist to guide them through rather than a sober member of alcoholics anonymous, who is unlikely to have professional counselling skills.
We offer 12-step therapy at Detox Today. We have both male and female therapist who are skilled in the 12-steps programme who can educate you in the steps. Your 12-step therapist should have certifications in counselling, relevant training and practice in the field.
It’s wise to schedule an initial consultation or interview with potential practitioners to assess their approach, values and compatibility with the client’s needs. Trust and rapport are crucial in this therapeutic relationship, and the practitioner should have a supportive and non-judgmental approach. Recovery can be challenging and having a compassionate and understanding professional by their side can make a significant difference.
In addition to the 12-steps, some people also have issues or problems that the 12-steps do not directly address. Often clients have bereavement, abuse, sexuality or gender issues, so finding a therapist who has skills in other forms of counselling, or has an approach to continued care and support after completing the 12 steps, can be beneficial. Speak to us today if you’d like to find out more about the 12-steps, how they work, what it entails or if you’d like to book an appointment with a 12-step therapist.
The Benefits of 12-Steps For Alcohol Addiction
While 12-step counselling can be effective for various addictions, it has its foundations and greatest number of successes in the treatment of alcohol addiction. The principles and support provided by 12-step programs align well with the challenges faced by people struggling with alcohol dependence. Here are some key benefits of 12-step counselling for alcohol addiction:
Community and Support
12 Steps groups and meetings can offer a supportive community of people who have faced similar challenges. Sharing experiences, insights and coping strategies with others who understand the struggle with alcohol can provide a sense of belonging and encouragement.
Accountability and Structure
The structured nature of 12-step programs, with regular meetings and step-by-step guidance, provides people with a sense of accountability and direction. This structure helps individuals stay on track and maintain their commitment to recovery.
Self-Reflection and Personal Growth
The steps involved encourage self-reflection, introspection, problems solving and personal growth. By addressing underlying emotional issues, character defects and destructive patterns, people can experience profound transformation and healing.
Connection and Spirituality
The inclusion of connection to others, a higher power and spirituality in 12-step programs offers a source of strength and guidance for those in recovery. It provides a framework for finding meaning and purpose beyond addiction.
12-step programs are all about ongoing support and helping others on the path to recovery. people are encouraged to stay connected to the program, attend meetings and provide support to fellow participants. This lifelong support system helps maintain their recovery and find fulfilment in helping others.
Summary Of 12-Steps As A Recovery Therapy
12-step counselling programs have become a ray of hope people seeking recovery from addiction. By embracing the principles and steps outlined in these programs, people can embark on a transformative journey towards healing, self-discovery and personal growth. The power of community, self-reflection and accountability offers a solid foundation for people to overcome addiction and build fulfilling lives.
At Detox Today, we have seen people overcome all kinds of alcohol addiction, chronic drinking and extreme alcoholism thanks to the 12 steps and grow to become upstanding sober people with extraordinary great lives. Get in touch if you need or someone you know needs advice on how to get and stay sober.
References & Sources
Seek Professional Help
Alcohol rehab offers people struggling with alcohol addiction a comprehensive and structured approach to recovery. Inpatient alcohol rehab, in particular, provides the highest level of care, ensuring the safety, comfort, and support needed during the detoxification process and beyond. Through a combination of medical supervision, counselling, therapy, and behavioural interventions, individuals can develop the skills and strategies necessary to overcome alcohol addiction and maintain long-term sobriety. If you or someone you know is struggling with alcohol addiction, seeking professional help through an alcohol rehab program can be the first step towards a healthier and sober life.
Written by James McInally
This article was written by James McInally,
James is an addiction specialist and counsellor, mindfulness teacher, NLP practitioner, fitness instructor and well-being coach. He has helped hundreds of people overcome alcohol misuse.
Last updated on 26 October 2023
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