Alcohol-related deaths in the United States doubled from 1999 to 2017. On top of that, alcohol use increased significantly after the outbreak of COVID-19. The National Survey on Drug Use and Health from 2019 found that more than 25% of American adults have engaged in binge drinking each month, which is defined as a pattern that leads to a blood alcohol of 0.08 or higher.
However, Boston University reports sales jumped more than 50% in the first few weeks of lockdowns. David Jernigan, a professor at the university’s School of Public Health, says: If a couple has gone from sharing a bottle of wine once a week over a couple of dinners to now having a box of wine they buy once a week and have with dinner every night, that is a very significant change in drinking pattern, which brings with it different risks—both biological and social—than occasional weekend drinking.” A recent article in The Atlantic claimed, “America has a drinking problem.”
So how can behavioral health professionals better support people in this situation?
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Impacts of Alcohol Use Over Time
There are many reasons people drink alcohol. At one end of the spectrum, it can be a fun and healthy social activity enjoyed with friends and family. At the other end, it can be used to take the edge off emotional or physical pain or avoid dealing with difficult circumstances.
In the short-term, alcohol is known for its mood-altering qualities, which means misuse can have serious effects. It can cause mood swings, lapses in judgment, and physical impairments, among other things. It’s one of the leading causes of death for young people, due to the fact that it often plays a role in accidents. It’s also commonly associated with issues such as family violence.
Long term, however, alcohol use is linked to chronic health issues such as liver disease, heart disease, high blood pressure, stroke risk, and several types of cancers. Over time, it causes scar tissue to build up inside the liver which can impair its function and even lead to death.
Therapeutic Approaches to Alcohol Use
There are generally two types of people to seek therapy in relation to alcohol use.
The first category includes people who are worried about the amount they’re drinking. They could be constantly waking up hungover, finding themselves in unpleasant or dangerous situations, or noticing a lack of self-control when it comes to pouring a drink at the end of the day. People in this category are often much more open to therapeutic support because they’ve willingly sought advice.
The second category includes people who come because their family members or friends insist. It’s likely that denial will be a key part of early discussions, which can make it a much more difficult space to navigate. As with most subjects, the key is to start with education and awareness.
Here are some techniques you may find helpful.
Goal Setting to Reduce Alcohol Use
Alcohol use is definitely an area where clients can benefit from a minimalist approach to intervention. Once they’ve understood and accepted the problem, it’s best to let them take the lead and manage their recovery themselves as much as possible. As a result, your clinical approach could include things like keeping a record of alcohol use, removing alcohol from the house, introducing alcohol-free days, slowing down the rate of drinking, and keeping busy with other tasks.
Goal setting is a vital part of this. Harvard Health recommends working with a primary care physician to determine what level of drinking is right for each client. However, the CDC recommends a maximum intake of two drinks per day for men and one drink per day for women (or less). In order to work, it must be specific and measurable. An accountability partner may be helpful.
Changing Thought Patterns Around Alcohol
Cognitive behavioral therapy (CBT) is one of the most powerful items in a modern therapist’s toolbox. It’s conversational but highly specific, focused on changing unhealthy thoughts and feelings into healthy ones. It can make a difference very quickly, with excellent long-term results.
This is because it hones in on the self-defeating patterns that cause people to reach for the bottle in the first place. It’s a powerful tool that can help clients learn to recognize the situations that are most likely to lead to drinking, identify and avoid triggers, cope with cravings, and improve self-control. There are two key parts: analysis and training. Analysis focuses on causes and consequences, while training focuses on coping. What thoughts are actually helpful?
Unlearning old habits is hard work, especially when it comes to facing the issues at the core of the client’s distress. However, learning to identify self-destructive thoughts and learning new ways of managing them is a significant step on the path towards recovery.
Single Session Alcohol Use Intervention
Motivational interviewing is a technique that combines listening and directing. It can be very successful in therapy, particularly when it’s used after a significant event such as a car accident.
This conversation style is curious and respectful, designed to help people make their own realizations about what has happened and what they need to do to rectify the situation. It’s important that therapists treat the client as an equal, which means avoiding unsolicited advice, to avoid coming across as judgmental or condescending. The core elements include:
- Partnership: Treat the client as an equal.
- Evocation: Allow them to find the reason to change.
- Acceptance: Avoid judgment and seek understanding.
- Compassion: Prioritize the client’s welfare.
Counseling on General Behavioral Health Issues
Alcohol use disorders don’t develop in a silo. It’s very common that they develop as a symptom of another issue, such as untreated depression or anxiety. Depending on the stage the client has reached in their recovery journey, there are two ways you can guide them through the process:
- Start with an alcohol-specific treatment plan designed to help the client better understand the issue, why it’s a problem, what effect it’s having on their loved ones, and what steps they can take to begin the healing journey.
- Start with the underlying psychological problems that triggered the client’s excessive drinking. Once the client has identified and begun working on the root cause, it’s entirely possible that this may alleviate the alcohol use disorder.
If this is outside your area of expertise, you can also make a referral to another provider.
Share Your Alcohol Use Disorder Expertise
If you’re an expert in alcohol use disorders, and you’d like to continue the conversation with new clients, join Ravel Mental Health. It’s an inclusive online booking platform for therapists that is set to revolutionize behavioral health services. You can create profile pages using a comprehensive set of filters to ensure prospective clients understand exactly how you can help.
Alcohol use disorders are a great example. All therapists can identify and treat issues such as anxiety and depression, but clients with alcohol use disorders may benefit from your experience. Make sure they can find you when they need you by being among the first to join.
Want to help more people? Sign up to Ravel Mental Health.