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Alcohol, especially when consumed in excess, can lead to several complications. Not only does alcohol interfere with people's daily lives, it can lead to many health conditions. For alcoholics seeking treatments, the current methods available to them are not always effective. In a new study, researchers examined the effects of a combination of therapies. The team studied a stepped-care approach in which patients with alcohol dependence were given medications followed by psychotherapy and found that this approach was effective in reducing or delaying people from relapsing to heavy drinking.

For this study, researcher Michael Berner, a professor of psychiatry at the Freiburg University Medical Center and a chief physician at the Rhine-Jura Hospital for Psychiatry, and colleagues recruited 103 adults with alcohol dependence that had experienced a heavy relapse after using anti-craving medication or placebo. 86 of them were males and 23 of them were females and they were all randomized into two groups with 54 in one and 55 in the other. The first group of 54 was given medication, medical management and cognitive-behavioral psychotherapy, which was given individually. The second group of people was only given medication and medical management.

"All therapies were effective," said Berner. "One must not forget that the medical-management group, our control condition, meant that somebody spent time with the patients and did talk to them; you might think of this as a formal yet brief psychosocial intervention to increase motivation and compliance. But altogether those patients who started psychotherapy and continued [for a period of time] had a significant, additional benefit over those in the control group."

The researchers reported that even though they found this two-step approach effective, a lot of the patients ended up skipping psychotherapy even after they gave their consent. The researchers believe that psychotherapy attendance rates must be improved. The researchers believe that the subject of psychotherapy must be introduced early on between the doctor and the patient.

"There is a difference between motivation, wanting to do something, and volition, managing to do things," explained Berner. "It is often characteristic of alcoholic patients, that they are motivated to do things like quitting or attending additional services, but do not manage to actually do so in real life. In our study, our patients had to see a new person to start the psychotherapy, which many did not do. Many patients that did not attend psychotherapy preferred continuity over the change in routine. This would perhaps have been different if the same person would have delivered the psychotherapy. And it would have been, and probably should perhaps be, different in the 'real world' where health professionals might work closer together in the same building."

The study was published in Alcoholism: Clinical and Experimental Research.