Overview of Psychosocial Interventions

Psychosocial interventions or treatments encompass a wide range of non-pharmacological approaches commonly used to treat alcohol and other drug use disorders. These interventions generally focus on the individual (their beliefs, emotions, and behaviour), their social context, including family, community and cultural factors, and the interaction between these domains. 

Psychosocial interventions encompass: 

• treatment content (that is, the skills, strategies and theoretical orientation of treatment); 
• treatment process (that is, the interaction between the clinician and patient, which includes the strength of engagement, interpersonal interactions, and ability to work on shared treatment goals). 

Psychosocial treatment research increasingly supports the view that effective treatment outcomes require sound integration of treatment content and process. 

Many psychosocial interventions derive from social learning theory. They share the basic tenet that, although biological and genetic factors play a significant role in the aetiology of substance use disorders, problematic patterns of alcohol and other drug use are learned in a social environment and can, therefore, be replaced by new, more adaptive learned behaviour. 

Effective psychosocial interventions help patients address their drinking problems by engaging their motivation and other resources and affecting cognitive, behavioural, and social changes with respect to drinking. Where alcohol use is conceptualised as a maladaptive attempt to manage stress, distress or other negative emotional states, psychosocial interventions can be particularly useful in teaching more functional coping skills. 

The most widely used psychosocial approaches that have received consistent empirical support are: 

• Brief interventions (see Chapter 6) 
• Motivational Interviewing 
• Cognitive Behaviour Therapy 

A psychosocial intervention can be used as a standalone treatment, in combination with other psychosocial interventions, and/or in conjunction with pharmacotherapy. Consistent evidence shows that people who receive these interventions benefit substantially, and at follow-up show clinically significant reductions in their alcohol consumption, increases in number of days abstinent, and improvements in overall functioning.