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Two prominent models have gained wide application in the management of drinking problems; Alcoholic Anonymous (AA) and behavior therapy. Reviews and analysis have depicted that the two models are characterized with divergent and opposing views particularly on the nature and the best methods of managing the drinking problems. Neutral inquiries on the contributions to the scope of the drinking menace and analysis of the two models to come up with similarities in the theoretical approaches have been limited since their inception in 1970. AA has relied mainly on single-group evaluation studies, unlike behavioral therapy that has enormous empirical backing of the association, as the basis for supporting its effectiveness.
The theoretical underpinnings behind AA practice mainly delve on the nature of alcoholism, commitment to change, aligning preoccupation away from oneself, changes at intrapersonal and interpersonal levels, improvements in spiritual life and life long commitment to maintain change. On the other hand, behavioral therapy is premised on the concepts laid out in experimental studies that overly govern the cognitive, affective and behavior of the human beings. It is paramount for the motivation to occur while actively involving the alcoholic in the recover program in order to achieve cognitive, spiritual and change in AA model. Behavioral therapy stresses the need for enhanced individualized assessment coupled by a treatment plan that takes into consideration the client behavioral and interpersonal changes required at specific periods of time. The article argues application of common approach to enhance the integration of the two models thereby addressing the contrasting values and limitations in the individual models.
The article by McCrady (1994) offers contrasting and comparative analysis of the behavioral therapy and AA models. In a nutshell, it analyses the theoretical foundations with particular interest in the change process that govern the treatment practices employed in AA and behavioral therapy. Various possibilities of integrating the two approaches and their implication to furthering the development of the management of the problems are discussed in depth. To conduct an in depth analysis of the models, it is imperative to have a closer look at their benefits and problems during their utilization in the recovery process. Despite its lack of wide application, the behavioral therapy has wide and credible support on its association unlike the AA model that has relies on single studies that do not offer scientifically sound results.
The AA model offers several advantages vital in helping the alcoholics recover from their problems. Motivational benefits aimed at instilling confidence on the alcoholics to embrace change at the personal and behavioral level through agitating for commitment to upholding abstinence and appreciation that recovery is a long term process have received wide utilization. Motivation on a day to day basis with emphasis on encouraging alcoholics to continue attending recovery meetings regardless whether the behavior relapses helps to add more conviction to the client. More importantly, putting the patient at centre stage of the program through promotion of close relationship with the sponsors while ensuring they are overly involved in time scheduling improves the effectiveness of the program.
However, the models reliance on spiritual cure as the single most factor in influencing long-term sobriety offers some limitations in its effectiveness. The fact that spiritual care cannot address the biochemical root of the problems is believed to offer a solid explanation of the increased cases of relapses. The spiritual aspect of the AA is also counterproductive because of its tendency to be less punitive and rigid when trying to brainwash the client into believing their conceptual principles hence leaving them powerless in decisions making.
On the other hand, behavioral therapy premises the recovery program on individual basis making it easier in assessing the progress in the client. Integration of principles of the psychological theories in the therapy enhances its effectiveness unlike the AA model. Application of reinforcement and punishment provides the necessary encouragement that is imperative in effecting and maintaining the changes in drinking. Incorporation of motivational techniques such as compassionate feedback and educating on the consequences of drinking throughout the therapeutic period helps in maintaining the behavioral and interpersonal change on course. Rigidity and individualized treatment plan coupled with punishment for defiance encourages the alcoholic and brings the appropriate discipline during the program.
Nevertheless, its rigidity might work against the efficacy of the program since the alcoholics might relapse after completing the therapy program. In view of this, lack of viewing the program as a life time commitment and the time- directed recovery plan may fail to take into consideration the nature of learning in specific persons. In addressing abnormal psychology, the behavioral therapy is usually less effective because of the nature of disorders. Taking into account that the clients are unable to control the functioning of their bodies and mind, behavioral therapy fails in acknowledging that relapse is part of the program owing to its rigidity. However its premise in cognitive and affective behavior is important in understanding the mental health disorders thus forming a major component in the holistic therapy used in treating them.
Behavior change therapists should consider improving the concepts in the two models thus enhancing their effectiveness in addressing a broad range of psychological disorders. In line with the improvement, AA and behavioral therapy should be improved to cater for the changes observed in the medical field. In essence, integrating the two models to cover the individual conceptual shortcomings offers the best approaches in addressing disorders in abnormal psychology. Moreover, embracement of patient centered approach can prove useful in managing mental health disorders. Assessment of the social environment of the patient while embarking on learning the indicators of improvement is imperative in informing the decision of whether to introduce the patient into AA or behavioral therapy.
The application of the person centered approach is paramount because the patient is at the centre stage of the treatment plan thereby ensuring their values are respected and expectations are met. Involvement of the close relatives and improvements in the communication process with regards to the risks of the disorder and benefits of receiving treatment should be enhanced in the model. Communication facilitates the development of tailor-made solution to individual patients unlike the traditional approaches where the patient is taken through treatment plan devised at the will of the therapist. Finally, holding regular assessment of the progress of the therapeutic process should be encouraged to help redirect the program or address encountered problems.
The AA and behavioral therapy offer essential frameworks that are useful in addressing the drinking problems. However, improvements in terms of personalizing the plans to suit each patient are needed in order to improve its applicability in the treatment of abnormal psychology disorders. More importantly, integration of the conceptual principles to cater for the changes in the medical field must be encouraged.
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