“thinking out of the box”: clinical and practical aspects of moderate drinking strategies arnold...
TRANSCRIPT
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“Thinking Out of the Box”: Clinical and Practical Aspects
of Moderate Drinking Strategies
Arnold M. Washton, Ph.D. & Scott Stern, LCSW, CADAC
RECOVERY OPTIONSNew York, NY & Princeton, NJ
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Topics
1. Prefatory remarks2. Why moderation?3. How to enhance treatment attraction, engagement,
retention 4. Alcohol’s effects5. How much drinking is “too much”?6. Research on moderation7. Clinical assessment & goal selection8. Moderation strategies & skills
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To download copies of todays’ slides:
www.ModerateDrinkingOptions.com Downloads & Links page NASW Conference: “Moderate Drinking
Strategies”
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Some Helpful Resources
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Websites Niaaa.nih.gov Moderation.org ModerateDrinking.com SmartRecovery.org RecoveryOptions.us ModerateDrinkingOptions.com
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www.niaaa.nih.gov
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www.niaaa.nih.gov/publications
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Arnold M. Washton, Ph.D.Joan E. Zweben, Ph.D.
Guilford, 2006
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How I arrived at using moderate drinking strategies in my clinical practice
In 1975, started treating IV heroin addicts in an East Harlem clinic. Most continued drinking after stopping heroin.
Starting in early 1980s, started treating cocaine addicts who often did not want to stop drinking except after multiple alcohol-related relapses
Since the beginning, treated countless primary alcoholics who did not want to start with abstinence. Many refused treatment or dropped out prematurely.
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How I got here
Regrettably, I too often took the stance of “come back when you’re motivated and ready to stop”
For past 10+ years, I’ve offered moderation training as an initial engagement strategy for patients with serious alcohol problems and as a primary treatment strategy for many with less severe problems
Since closing my outpatient clinic in 1998, I’ve been in full time private practice treating high-functioning adults with alcohol and drug problems
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How I got here
Private practice affords me the flexibility to treat patients without being constrained by agency policies and politics
Patients seeking help with moderation or abstinence often find me through my website moderatedrinkingoptions.com and recoveryoptions.us
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How I got here
Entering the field as a psychologist trained in both cognitive-behavioral and psychodynamic therapies, I gravitated naturally toward more individualized, integrative, non-dogmatic approaches
I place great value on establishing a good working therapeutic relationship with my patients, seeing this as the primary vehicle for facilitating positive change
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Prefatory Statement
Total abstinence is without question the safest goal for anyone who has developed an alcohol problem
This is especially true for anyone who has developed a serious problem that qualifies for (or approximates) a diagnosis of Alcohol Dependence
Moderate drinking is generally NOT a realistic or appropriate goal for alcoholics
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Prefatory Statement
I am not here as a proponent of any singular approach, philosophy, model, or program:Harm ReductionModeration ManagementDisease Model12-StepCBT/Social Learning Psychodynamic (Self-Medication)
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Prefatory Statement
I support and utilize any and ALL of these, depending on what makes the most sense for a given patient and most importantly what seems to work best!