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ContrAl Treatment
The ContrAl Method uses selective extinction to reduce alcohol drinking without weakening other behaviours. The medication
used in the treatment (Naltrexone) is
begun in association with specific clinical protocols while the client
may still be drinking, thus eliminating the need for prior detoxification
in many cases. Instead, drinking usually decreases gradually as the treatment
weakens the drive for alcohol. It thus differs from most other treatments
that impose an external barrier to drinking without removing the internal
cause. The Method is designed also to improve the persistence of beneficial
effects: in most complying cases it should provide a long-term solution.
The treatment at ContrAl Clinics is provided in an outpatient programme.
Counselling follows cognitive-behavioural framework and focuses on decreasing
alcohol consumption. The client's physical and mental condition are assessed
prior to treatment, and the few for whom naltrexone is contraindicated
(e.g., with severe liver cirrhosis) are refferred to some other form of
treatment. Then the drinking habits and amounts are discussed in detail
with the client, along with perceived reasons for drinking and the ways
of affecting the addiction. The theory and the method of treatment are
described in detail, as clearly and graphically as possible in order to
assure the best atmosphere for the treatment and compliance. The stimuli,
situations, and moods eliciting drinking are discussed in order to provide
an understanding of the behaviour. Clients keep a detailed diary of their
drinking, naltrexone use, and reactions. Alternatives to drinking are explored
and considered. The later stages of the programme focus on thinking about
the future and the various possibilities provided by a new life style.
Client dignity is assured; there is no need for self-effacement since the
motivation for alcohol is reduced by extinction. Excessive drinking is
simply a case of a behaviour having been learned too well - somewhat like
fingernails that have grown too long. The ContrAl Method provides a means
for trimming.
Each client establishes his/her own goals for the programme. The general
goals are to decrease the dependency upon alcohol drinking and to develop
the ability to control one's own consumption.
In short,
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The programme includes laboratory tests and prescriptions, together with
a systematic series of sessions with medical doctors and psychologists
trained in both the theory and use of pharmacological extinction.
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The basic treatment period lasts at least three months; in practice, usually
4-6 months. During and after the basic period, additional and follow-up
sessions are provided according to individual needs. Sessions are mainly
individual, but also couples and family sessions can be arranged.
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Abstinence is not required prior to the beginning of treatment. In fact,
alcohol can be consumed during the initial phase of the programme. Drinking
tapers off gradually in the course of the treatment as the desire for alcohol
is being diminished.
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Selective extinction assures that only alcohol drinking is weakened; other
behaviours may be enhanced; the number of days initially on naltrexone
is reduced.
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Continued naltrexone is provided as needed.
Should you wish to read Frequently Asked Questions, please click here. There are also plenty of
scientific studies on the subject.
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