Chapter

Alcohol Use Disorders

Adult Disorders

II. Specific Disorders

  1. Kevin A. Hallgren1,
  2. Brenna L. Greenfield2,
  3. Benjamin Ladd3,
  4. Lisa H. Glynn4,
  5. Barbara S. McCrady5

Published Online: 25 JUN 2012

DOI: 10.1002/9781118156391.ebcp002007

Handbook of Evidence-Based Practice in Clinical Psychology

Handbook of Evidence-Based Practice in Clinical Psychology

How to Cite

Hallgren, K. A., Greenfield, B. L., Ladd, B., Glynn, L. H. and McCrady, B. S. 2012. Alcohol Use Disorders. Handbook of Evidence-Based Practice in Clinical Psychology. 2:II:7.

Author Information

  1. 1

    University of New Mexico

  2. 2

    University of New Mexico

  3. 3

    University of New Mexico

  4. 4

    University of New Mexico

  5. 5

    University of New Mexico

Publication History

  1. Published Online: 25 JUN 2012

Abstract

Alcohol use disorders have a 30% lifetime prevalence rate and are associated with numerous problems, including disease, injury, social impairment, occupational dysfunction, domestic violence, and economic burden. Despite the availability and demonstrated efficacy of several treatments, many providers fail to use evidence-based practices. Moreover, most treatments deemed efficacious yield only modest improvements in outcomes, and no single modality is considered universally superior. A review of randomized clinical trials, meta-analyses, literature reviews, and consensus panel recommendations identified nine treatments with evidence for efficacy in the treatment of alcohol use disorders: cognitive behavior therapy, contingency management, cue exposure therapy, community reinforcement approach, behavioral couples and family treatment, brief interventions, motivational interviewing and motivational enhancement therapy, 12-step-based therapies, and case management. Therapist factors shown to influence treatment outcomes were also reviewed. Treatments were found to vary considerably in the quantity and rigor of studies testing their efficacy. Although large-scale treatment studies have identified few client-treatment matching effects, some client characteristics may determine which treatments are a better fit. For example, behavioral couples and family treatment or the community reinforcement approach may be optimal when a significant other is available to participate in treatment, motivational interviewing and specific therapist techniques may be helpful with resistant or angry clients, and brief interventions may be optimal when time and resources are limited. More research is needed to examine treatment efficacy for clients with co-occurring psychiatric disorders or drug use, and to determine the effectiveness of these treatments in real-world settings.

Keywords:

  • alcohol treatment;
  • adult;
  • evidence-based practice;
  • randomized controlled trial;
  • meta-analysis;
  • consensus panel;
  • review