Psychological Treatments For Alcoholism Are Ineffective
Reanalysis of data collected from the most expensive research into the treatment of alcoholism has found little support for the use of psychological therapies.
The research compared a number of psychosocial treatments (Cognitive Behavioural Therapy, Motivational Enhancement Therapy and Twelve Step Facilitation - based on the method used by Alcoholics Anonymous) and found that they accounted for only 3% of the variability in the patient's outcome. In other words, psychological therapies hardly had any beneficial effect in treating alcoholics.
The failure of current methods of treatment is particularly highlighted by the fact that this study found that, in clinical trials, untreated alcoholics showed significant improvements - almost as much as those who received treatment.
How is it that new therapies are often adopted before they have been properly tested? Part of the problem for psychology, despite the lip-service paid to the importance of the evidence base, is the relative ease of introducing new treatments. Unlike pharmaceutical treatments, psychological treatments are unlikely to have damaging side-effects. Combine this with the problem for much scientific research that negative results often go unreported, and the seeds are there for a proliferation of ineffective therapies.
Despite this seeming like bad news for psychological approaches to alcoholism, it shows the importance of the scientific method in psychology. The strength of any science is founded on its ability to admit when the evidence does not support the treatment methods currently used. And for alcoholism this evidence shows little support for psychological treatments.
This kind of evidence, however, does not show that psychological therapies are never going to be any use in the treatment of alcoholism, only that the correct method has not yet been found. Admitting failure is the first step towards finding a better way. This is why, sometimes a negative result is actually a positive one.
Are alcoholism treatments effective? The Project MATCH data. [Abstract + link to free PDF of study]Press release
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Re. AA:
Maybe it might not be perfect, but the 12 step programme has certainly changed the lives of a lot of alcoholics. I joined AA 8 months ago and have not had a drink since. Prior to that, I was drinking in excess of 100 units per week and experienced mild physical withdrawal if I didn't have alcohol every day.
Librium helped a small amount when I was given it on a psych ward to stop the DTs, but the only thing that has helped me to abstain completely is AA.
The spiritual improvements were almost immediate and noticeable to people around me who didn't know I had stopped drinking - I was calmer and more reliable.
I have had psychological cravings for a drink, but this only happens when I have not been to an AA meeting for a few days. I have no idea how it works, but the AA meetings, contact with other members and at least some work on the 12 steps (I reached step 4 in May, but have let this drop a bit since then) have made it possible for me to live an alcohol-free 8 months, one day at a time.
Cat
Hi Cat,
Just to make clear that this particular study was evaluating a version of the 12 steps in isolation, rather than the work of Alcoholics Anonymous.
My guess would be that it is the support and understanding of other people in a similar situation to yourself, as well as the other aspects of AA, that is more useful than the actual 12 steps in isolation. Just a guess - I'd be happy for anyone's view...
In any case, I'm really happy to hear the AA's programme was effective for you and thank you, as ever, for sharing your experience.
Jeremy
Thanks Jeremy. I suppose I will find out if it works in isolations if I continue with my 12 steps while I am in the Therapeutic Community - I will have support, but not AA support.
I was so glad to see your site today - when I tried to read it yesterday, a screen came up with an error message and I got a bit worried!
Cat
Someone seems to have the statistics mixed up.
Project MATCH showed that Twelve Step Facilitation had equal to and sometimes better improvement rates that CBT - around 40%.
Twelve Step Facilitation had even better recovery rates if abstinence was the main goal.
Interestingly spirituality, as taught by therapists, had no impact on abstinence rates. However, when alcoholics attended AA the abstinence rates due to spirituality shot up.
Hi fredjoiners, this post is referring to a reanalysis of the Project MATCH data, not the original data. See the link to article at the end of the post.
Jeremy,
You have got it totally and utterly wrong.
Your analysis id flawed, your comments are flawed and you are trying to mislead people.
I know its a cliche, but you may be in denial of something and trying to avoid facing up to reality.
Recently I spoke to a psychologist who was trying to teach 'controlled drinking' to confirmed alcoholics. You are also trying to decieve alcoholics for what ever alternative aganda.
Hi anonymous, I don't have any alternative agenda that I'm aware of. When I wrote this post I was just reporting the research.
Remember this study is not saying alcoholics can't get better. It's saying the treatments psychologists used didn't make much difference. And it's just this study...
re AA i am sorry to inform you that it is in fact a perfect progarm if worked to the end ie step 12 and then you work it every day not only do you not have to drink but it makes you a calm and better member of society think of it as a progam for lving