Self-Help Treatment

Once the crash has abated, the patient should be reassessed and treatment recommendations made. Psychosocial treatments are the mainstay of treatment for cocaine addicts. Intensive outpatient programs and partial hospitalization programs are most effective during the initial phase of treatment. Psychotherapy and self-help treatment can help the patient devise means to manage craving and sustain sobriety. 

Jorm AF, Christensen H, Griffiths KM, et al. Effectiveness of complementary and self-help treatments for anxiety disorders. Med J Aust. 2004 181(suppl) S29-S46. 

Alcohol Treatment Settings and Services Types of Settings and Services Pharmacological Treatment Effectiveness of Alcohol Treatment Nonpharmacological Professional Treatment Self-Help Treatment Effectiveness of Pharmacological Treatments... 

Effectiveness of Drug Treatment Nonpharmacological Professional Treatment Self-Help Treatment Pharmacological Treatments Promising Treatment Techniques Special Topics in Alcohol and Drug Treatment... 

We have spent so much space on AA and its relatives because they arc by far tlic most prevalent and influential self-help treatments for alcohol and drug use disorders. Perhaps stimulated by AA s success, other t pcs of self-help groups for alcohol and drug problems have been organized. One important example is Women for, Sobriety (WFS), which began in 1975 (Women for Sobriety, 1985). WPS groups arc now available throughout the United States and in other countries as well. 

Alcoholics Anonymous (AA) is a self-help organization for people whose common goal is recovery from alcoholism, and it is the most widely accessed resource for individuals with alcohol problems (McCrady and Miller 1993). The philosophy is based on the concept of alcoholism as a chronic disease that cannot be cured, but one that can be halted by means of complete abstinence. AA has described 12 principles or steps to guide those in recovery. Twelve-step facilitation, a manual-based psychotherapy to promote AA participation (Nowinski et al. 1992), was equally efficacious, compared with cognitive-behavioral and motivational enhancement therapies, in a large study of treatments for alcohol dependence (Project Match Research Group, 1997). 

As a researcher and therapist, I also do not like the use of colloquial terms such as addict or junkie. These terms, although potentially helpful for some who find recovery in self-help programs, are not useful for everyone with a drug problem, and can be demeaning to some. In fact, some of my clients have been put off by such labels in treatment, and found them stigmatizing, and therefore potentially harmful. Besides, such terms are highly pejorative and uncomplimentary descriptions of behavior and are not diagnostically accurate terms (i.e., are not defined in the DSM-IV). I choose not to use these terms with my own clients for these reasons. 

Stage Three Continuing Care. After the rehabilitation phase, the patient enters a period of continuing care. At this point, treatment often transitions to community resources such as self-help groups. In many cases, continuing care patients move beyond the need for intensive psychiatric treatment but continue to require the support of others as they move through the long-term recovery process. 

Alcohol. It may seem odd to list alcohol among the treatments for insomnia, bnt it has long been among the most common self-administered treatments for insomnia. Alcohol usually does help the person fall asleep, but it is otherwise an extremely poor treatment for insomnia. It can lead to fragmented sleep later in the night, not to mention the potential for hangover and tolerance. In fact, with repeated use, alcohol itself can produce insomnia. Even without taking the social and medical consequences of frequent alcohol use into account, alcohol has no place in the treatment of insomnia. 

Alcoholics Anonymous, the great self-help group-therapy movement, is the only established treatment for alcoholics. Until much more is known about the personal (biochemical and psychological), familial, and social factors that contribute to alcoholism, so it will remain. Most new therapies are merely adjunctive to AA and will continue to be so until it is shown that they have therapeutic value when used alone. In my view, psychedelic therapy is best used as a preparation for AA. 

Self-help group treatments (see Hammond, 1995 Lawless, 1995 Dougans, 1996 Hoffman, 1996 Thomas, 1997 Mitchell, 1997 Warner and Gunawant, 1997 MacDonald, 1998 Liechti, 1998 and General References)... 

The most effective treatment for schizophrenia incorporates a multidisciplinary approach in which antipsychotic medications are a necessary but insufficient component. Medication must be complemented by specific psychotherapy modalities, including family therapy, skills training, psychoeducation, supportive intervention, vocational training, and self-help groups. 

The history of self-medication movement began in the late 1970s or early 1980s. Within this time period, there has been a huge movement towards self-help or self-care manifested by a positive approach to wellness and a determination to be involved in the decision making process regarding illness and its treatment. Availability of advanced technology such as computers and the Internet have allowed consumers to have... 

Motivation to Change Change without Formal Treatment Self-Help Groups Alcoholics Anonymous Other Self-Help Groups Models of Substance-Use Disorders Five Model Categories Biopsychosocial Model Professional Treatment Assessment and Goals... 

With problem recognition and a source of motivation to change, the next step is a decision about how change will occur. We consider in turn problem resolution on one s own, the use of self-help groups, and the use of professional treatment. services. 

In this section we briefly describe the peer self-help movement organized for helping individuals identified as alcoholics—Alcoholics Anonymous (AA). Because of space limitations we cannot describe in detail the major self-help groups for the treatment of drug problems, called Narcotics Anonymous (NA). NA is analogous to AA, however, and what wc know about AA can be applied readily to NA. 

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