A dualistic model for group treatment of alcohol problems: abstinence-based treatment for alcoholics, moderation training for problem drinkers

This article provides a clinical framework for a dualistic group treatment model: abstinence-based treatment for alcohol dependent individuals and moderation training for problem drinkers. The major premises of these models are set forth, compared, and contrasted. An integrated approach for synthesizing these models is then detailed along with suggestions for clinical implementation and management of countertransference.     

Treatment of grief and mourning through EMDR: Conceptual considerations and clinical guidelines

IntroductionEye Movement Desensitization and Reprocessing (EMDR) is an empirically-supported psychotherapeutic approach for treating trauma, which is also applicable to a wide range of other experientially-based clinical complaints. It is particularly useful in treating grief and mourning.Literature findingsEMDR is guided by the Adaptive Information Processing Model (AIP), which conceptualizes the effects of traumatic experiences in terms of dysfunctional memory networks in a physiologically-based information processing system. Numerous empirical studies have demonstrated EMDR's efficacy.DiscussionThe death of a loved one can be very distressing, with memories and experiences associated with the loss becoming dysfunctionally stored and preventing access to adaptive information, including positive memories of the deceased. EMDR can be utilized to integrate these distressing experiences and facilitate the assimilation and accommodation of the loss and movement through the mourning processes.ConclusionApplying the eight phases of EMDR to grief and mourning can yield potent clinical results in the aftermath of loss.     

Ethical considerations and training recommendations for philosophical counseling

Philosophical counseling is a diverse and burgeoning type of mental health service delivery. Despite competing approaches to theory and practice, the field has largely strayed from an ethical critique of its methodology and counselor training requirements. This article outlines several ethical considerations and training recommendations that are proposed to bolster the quality and effectiveness of philosophical practice. As philosophical counseling gains increasing recognition in North America, recently established national organizations in philosophical practice may profit from revisiting their interim codes for professional conduct. Proposed training suggestions for counselor preparation my further assist institutions and board-regulated agencies in establishing competent and acceptable standards of client care.     

Family therapy with problem drinkers and drug takers: A pilot follow-up study

We report a retrospective outcome study of 36 problem drinkers and/or drug takers, treated with structural-strategic family therapy. The interval between treatment and follow-up varied from six months to two years. Follow-up data was available on 34 cases. Twenty had a pure alcohol problem and of these 18 had a good outcome at follow up. Five had a mixed drug/alcohol problem; of these all were free from problem drinking and four had become abstinent from drugs at follow-up. Of the nine patients with a pure drug problems, eight were abstinent from drugs at follow-up. Given the retrospective nature of this study and the lack of control data, these results must remain impressionistic but the implications of the findings are discussed.     

Approach and avoidance coping responses among older problem and nonproblem drinkers

The Coping Responses Inventory (CRI) was used to study coping among older problem and nonproblem drinkers. The CRI organizes coping efforts according to their focus (approach or avoidance) and method (cognitive or behavioral). Compared with nonproblem drinkers, older problem drinkers were more likely to use cognitive and behavioral avoidance responses to manage life stressors. Problem drinkers who experienced more negative life events and more severe stressors used both more approach and more avoidance coping. Those who had more financial and social resources relied more on approach and less on avoidance coping. Problem drinkers who relied more on avoidance coping tended to have more drinking problems and to report more depression and physical symptoms and less self-confidence. Positive reappraisal was associated with less depression and more self-confidence.     

The role of legal stigmatization in the enhancement of treatment goals for problem drinkers

Traditionally, labeling theory has neglected the active capacity of labeled individuals: the capacity to respond in several different ways to a stigmatizing label. Several writers have dealt with this issue, yet there is little data dealing with alternative responses to a stigmatizing label. This research tests the hypothesis that stigmatizing labels (in the form of legal intervention) can result in conventionalizing the problem drinker's behavior, and further tests two conditions deemed necessary before the hypothesis will be valid. The overall proposition—that stigmatizing labels can result in conventionalizing behavior—was supported by this research. The first condition—that the change agent responsible for the promotion of behavior change must be an ex‐practitioner of the relevant deviance and an identifiable role model for the client—was also supported. Finally, the second condition—that membership in the behavior‐changing group must be voluntary—was invalidated.