As a marriage and family therapist, you are likely to see many individuals, couples, and families in your practice who are experiencing or are at risk of experiencing significant alcohol-related problems.This Guide will: Since the 1930s, "alcoholics" — have been the primary focus of alcohol-related intervention efforts in the United States.
Based on the presenting problem, time constraints, family constellation, and other factors, you will need to determine whether the screening protocol is most effectively delivered in an interview format during the session, or whether it would be more effective to have individual family members complete paper or computer-assisted assessments.
The interview format allows you to probe further and reconcile inconsistencies, but it may not be an efficient use of limited session time — especially when multiple family members need to be assessed.
Criteria for alcohol use disorders are relatively clear, but establishing a "cut-off point" to separate problem drinkers from nonproblem drinkers is difficult, making population estimates more problematic.
As shown in Table 1, a recent national study found that approximately 21% of Americans experienced at least one alcohol-related problem in the prior year, and roughly 1 in 3 Americans engaged in risky drinking patterns.
Screening for alcohol problems should be considered only a first step.
Screening alone does not provide enough information to make either a diagnosis or an informed treatment decision. there are indications of risk, further assessment is required to confirm the problem and to determine its nature, extent, and severity.
Given the prevalence of drinking problems and the serious consequences that can result, brief screening procedures should be used routinely in your clinical practice to identify individuals who are experiencing or are at risk for experiencing alcohol problems.
Before making any treatment decisions, a multi-dimensional problem assessment, which covers alcohol use patterns, dependence signs and symptoms, and alcohol consequences should be performed.
The tools we recommend for screening and assessment are flexible enough to be used with adults in individual, couple, or family therapy contexts.
At times, you will be required to screen and assess alcohol use in adolescents, but such assessments are beyond the scope of this Guide.
These base rates for alcohol problems and risky drinking are high in the general population, but they are considerably higher in clinical populations.