Loeber S, Mann K
Klinik für Abhängiges Verhalten und Suchtmedizin, Zentralinstitut für Seelische Gesundheit, Mannheim.
Nervenarzt. 2006 May;77(5):558-66. doi: 10.1007/s00115-005-2000-z.
Past decades have seen enormous advances in the development and validation of evidence-based approaches to psychotherapy for alcoholism. While psychoanalytic and early behavioral techniques were the original basis of psychotherapy in this field, evidence-based approaches are now built up on the principles of motivational interviewing and cognitive-behavior therapy. Different techniques have been developed to modify preceding and persisting conditions favoring problem behavior, e.g., training in coping/social skills and the community reinforcement approach. According to the results of the project MATCH, one of the largest treatment trials, "cognitive-behavioral intervention" combines motivational enhancement therapy, the 12-step approach, and cognitive-behavior therapy, with the aim of providing new and even more efficacious psychotherapy for alcohol dependent patients. These very promising developments are beset with huge problems, however, insofar as few of the new evidence-based treatment approaches are accepted as standard treatment in Germany, in addition to which only a fraction of all alcohol-dependent persons in the country find their way into the care system, for various reasons. Early diagnosis and facilitation of access to the various treatment options available could be a future task for general practitioners and also for company / industrial medical schemes.
在过去几十年里，针对酒精成瘾的循证心理治疗方法在开发和验证方面取得了巨大进展。虽然精神分析和早期行为技术是该领域心理治疗的最初基础，但循证方法现在是建立在动机性访谈和认知行为疗法的原则之上。人们已经开发出不同的技术来改变有利于问题行为的先前和持续存在的条件，例如应对/社交技能培训和社区强化方法。根据最大规模治疗试验之一“MATCH项目”的结果，“认知行为干预”结合了动机增强疗法、12步方法和认知行为疗法，旨在为酒精依赖患者提供新的、甚至更有效的心理治疗。然而，这些非常有前景的发展面临着巨大的问题，因为在德国，很少有新的循证治疗方法被接受为标准治疗方法，此外，由于各种原因，该国所有酒精依赖者中只有一小部分能够进入护理系统。早期诊断和促进获得各种可用的治疗选择可能是全科医生以及公司/工业医疗计划未来的任务。
