Eells M A
Nurs Clin North Am. 1986 Sep;21(3):493-504.
Different types of alcoholism seem to exist, but all alcoholics progress through predictable stages. At any stage, interventions can be made by the nurse. The most effective, though unorthodox, interventions include the use of reversals (encouraging more of the same behavior) and the use of leverage (requiring treatment). These interventions focus upon the alcoholic. Family intervention, however, is a necessary condition for the complete recovery of the alcoholic and his family. The family system is a more powerful force than the addiction itself and has great potential for overcoming or sustaining the alcoholism. Using Bowen's family systems theory, the alcoholic family system was explained along with appropriate interventions for it. The major interventions included coaching the co-alcoholic to differentiate a self in the family system, to modify the habitual overfunctioner and pursuer roles, to bridge cutoffs, and to de-triangle oneself as the anxiety and tension rise in the family system. This article focuses on the alcoholic and the family system during the period of active alcoholism. Work on the family system is equally necessary and rewarding to family members once abstinence and sobriety are established. Families with alcoholism require several years of such work before the family system reaches an optimal level of functioning. Family systems work is a powerful, therapeutic adjunct to alcoholism treatment for the alcoholic and the participation of family members in Alcoholics Anonymous, Al-Anon, Ala-Teen, and Adult Children of Alcoholics is quite useful. Work with the alcoholic family system introduces a note of optimism for the future. As high levels of anxiety are reduced, opportunities are provided for differentiating a self in the family system, and triangling in of children becomes less necessary. The transmission of alcoholism and its effects are thereby lessened for future generations of children of alcoholics.
似乎存在不同类型的酗酒问题，但所有酗酒者都会经历可预测的阶段。在任何阶段，护士都可以进行干预。最有效但非传统的干预措施包括使用反向策略（鼓励更多相同行为）和运用影响力（要求接受治疗）。这些干预措施以酗酒者为重点。然而，家庭干预是酗酒者及其家庭完全康复的必要条件。家庭系统比成瘾本身更具影响力，在克服或维持酗酒问题方面具有巨大潜力。运用鲍文家庭系统理论，对酗酒家庭系统进行了解释，并给出了相应的干预措施。主要干预措施包括指导共同酗酒者在家庭系统中区分自我、改变习惯性的过度承担者和追求者角色、弥合关系中断以及在家庭系统中焦虑和紧张情绪上升时使自己脱离三角关系。本文关注的是酗酒活跃期的酗酒者及其家庭系统。一旦戒酒并保持清醒，针对家庭系统开展的工作对家庭成员同样必要且有益。酗酒家庭需要数年的此类工作，家庭系统才能达到最佳功能水平。家庭系统工作是酗酒治疗的有力辅助手段，对酗酒者而言如此，家庭成员参与戒酒互助会、嗜酒者互诫协会家属联谊会、嗜酒者互诫协会青少年分会以及酗酒者成年子女组织也非常有用。与酗酒家庭系统合作给未来带来了一丝乐观的希望。随着高度焦虑情绪的减轻，在家庭系统中区分自我的机会得以提供，让孩子卷入三角关系的必要性也降低了。由此，酗酒问题及其影响对酗酒者后代子孙的传递也会减少。
