Cynthia is a 27-year-old female who drinks four to five glasses of wine most days. She says it helps with the anxiety and sleep problems she has from a previous abusive relationship. She

Respond to the posts of your peers and provide a suggestion for another appropriate intervention, or the treatment of a biopsychosocial factor that they may not have addressed. If you are able to, give an example from your clinical experience. How was your suggested intervention received by the client in your practice, and how did they respond to the treatment?

Angela,

Cynthia is a 27-year-old female who drinks 4-5 glasses of wine a day. In this case it sounds like Cynthia is using this as a coping mechanism and to suppress certain emotions. I would utilize a screening tool such as the CAGE assessment to make a diagnosis of alcoholism. The cage screening tool questions focus on cutting down, annoyance by judgment received from her drinking, guilty feelings associated with drinking and eye opener. Alcohol use disorder is a chronic, relapsing condition, characterized by continued use despite harmful medical, psychological, and social consequences (Venegas & Ray, 2020). Once the diagnosis of alcoholism is made there are a few addictions specific therapies and treatment options available that we can explore.  

Addiction specific therapies include cognitive behavioral therapy, dialectal behavioral therapy, contingency management, and motivational interviewing. In CBT Cynthia can recognize learn to change maladaptive behaviors. DBT can be useful in exploring coping strategies and ways to manage her emotional response. Contingency management is based on operant conditioning principles. An example is providing rewards for periods of abstinence. Lastly, motivational interviewing comprises a specific set of strategies and techniques to help motivate ambivalent individuals towards behavior change (Arbuckle et al.,2020). In motivational interviewing a provider must engage, focus, evoke and plan with their clients. A great acronym to follow is known as OARS which stands for asking open ended questions, make affirmations, and reflections to the client. For example, an open ended question can consist of tell me about your alcohol use which promotes engagement. A benefit of motivational interviewing is that it can have Cynthia be more receptive to treatment by listening and promoting change. The benefit of this technique is that Cynthia would feel empowered and motivated to make better lifestyle choices. In addition, this technique can help Cynthia envision what life would feel like without alcohol. Additional therapies can be a support group such as AA to increase sobriety.

References 

Arbuckle, M. R., Foster, F. P., Talley, R. M., Covell, N. H., & Essock, S. M. (2020). Applying Motivational Interviewing Strategies to Enhance Organizational Readiness and Facilitate Implementation Efforts.  Quality management in health care,  29(1), 1–6. https://doi.org/10.1097/QMH.0000000000000234 

Venegas, A., & Ray, L. A. (2020). Comparing alcohol cue-reactivity in treatment-seekers versus non-treatment-seekers with alcohol use disorder.  American Journal of Drug & Alcohol Abuse,  46(1), 131–138. https://doi-org.westcoastuniversity.idm.oclc.org/10.1080/00952990.2019.1635138 

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