This chapter discusses therapeutic outcome research and dissemination of empirically based treatment for alcohol use disorders. The immediate goals of motivational interventions include empathizing with the client's perspective, resolution of the client's ambivalence about change, and reinforcing the client's statements about change. It is found that cognitive behavioral approaches are more effective when delivered in the context of a comprehensive treatment program and when working with individuals with less severe alcohol dependence. The community reinforcement approach (CRA) employs familial, social-recreational, and vocational rewards to assist in the recovery process. CRA emphasizes the development of skills to assist in employment, relationships, and recreation. Social skills training prepares clients to better navigate relationships with others by training clients in communication skills, assertiveness, or drink refusal techniques. Relapse prevention teaches clients cognitive-behavioral skills for the management of drinking problems and coping with high-risk situations to minimizing the likelihood of a return to patterns of problematic drinking. It is suggested that to be maximally effective, training for substance abuse treatment providers should be embedded in a larger intervention focused on external, systemic influences.
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