Dr. Washton's structured four-step approach to alcohol treatment for executives and professionals.
Our Four-Step approach is supported by decades of scientific research showing that relatively brief moderation-focused treatment can be very effective for problem drinkers. This approach forms the foundation of The Drink Smartly Program. The basic premise of moderation approaches is that mild to moderate drinking problems are learned (habitual) behaviors that can be changed. Utilizing a variety of cognitive-behavioral and other self-control techniques combined with practical straightforward advice, our approach helps clients take control of their drinking and empowers them to do so in a way that is consistent with their personal values, lifestyle, and goals.
One of the truly unique aspects of our Four-Step approach is its focus on both the behavioral and psychological aspects of problem drinking. Not only is heavy drinking a habitual behavior tied to certain types of overdrinking situations — and learning to find your off switch is a key part of changing those patterns — but it also can be a form of emotional “self-medication.” Problem drinking is often intertwined with other life problems. Many people drink excessively in response to feeling anxious, stressed, or emotionally upset, using alcohol as a coping tool to escape or forget. Since drinking never fixes emotional (psychological) problems, but almost always makes them worse, learning better ways to manage negative moods and emotions is an essential part our treatment approach. As psychologists and psychotherapists, we address not only the drinking behavior itself, but also the underlying emotional and psychological issues that frequently contribute to the development and maintenance of harmful drinking patterns.
The Four Steps
Once you have seen Dr. Washton for the initial consultation and decided jointly that moderation is an appropriate and realistic goal for you, the Four-Step program can begin.
Step One: Commitment and Planning
Make the commitment to change and develop a detailed plan including specific drinking limits to actually change your drinking behavior. For many but not all clients, this means starting with a [period of abstinence](/articles/sobriety-sampling) of at least 2 to 4 weeks. Some people taper down rather than stop completely, but temporary abstinence has unique benefits:
- It helps to break your habitual drinking pattern
- It establishes an alcohol-free baseline
- It allows you to experience daily/weekly life without any alcohol
- It helps to pinpoint your drinking triggers
- It prepares you to begin moderate drinking
Step Two: Drinking Control Skills
Learn and practice a toolbox of drinking control skills designed to help you succeed at moderating your drinking. This includes not only keeping an accurate log of your alcohol consumption, but also learning how to avoid or safely manage situations most likely to trigger problem drinking for you such as being in certain places, being around certain people, or experiencing certain feelings (e.g., anger, depression, boredom, anxiety, etc.). It also includes finding more rewarding nondrinking activities and healthy pursuits.
Step Three: Managing Slips and Relapses
Learn how to deal with slips and relapses, should they occur. The goal here is to prevent any incident of drinking beyond your new limits from leading you to get discouraged, give up on moderation, and go back to a regular pattern of harmful drinking. Few people who attempt to break a bad habit or other well-practiced problem behavior succeed without a hitch on the first try. Slips and relapses are certainly not required to eventually succeed at moderation, and there are some people who do get it right the first time around, but since mistakes do sometimes happen, it is important to be prepared. When a slip or relapse does occur, the most important thing is to turn it into a positive learning experience rather than react to it as proof that you simply don't have what it takes to succeed at moderation.
Step Four: Addressing Underlying Issues
Address other issues in your life that may have contributed to the development of your drinking problem and/or been part of the negative fallout from your drinking. These other issues may include, for example:
- Problems managing anxiety, depression, or other negative feeling states
- Communication problems and other relationship conflicts with your mate
- Self-criticism, guilt, and lack of self-acceptance
- Problems with anger management and assertiveness
- Job or career crises
Whatever these issues might be, as professionally trained and experienced psychotherapists, we are in a position to help you deal with whatever emotional and/or psychological issues are intertwined with your tendency to drink too much.
Other Helpful Tools
Medication
Some clients find it easier to moderate or abstain with the help of medication. Our complete guide to medications for alcohol problems covers these options in detail. Recent studies indicate that several new medications can reduce the likelihood of heavy drinking or make it easier to maintain total abstinence by offsetting changes in the brain caused by alcohol. These medications currently include naltrexone (Revia), acamprosate (Campral), and topiramate (Topimax). None of these medications are mood-altering, addictive, or make people sick when they drink. And they are more likely to be effective when combined with therapy or counseling — such as group therapy — than when taken alone.
Self Help Program for Problem Drinkers
We routinely encourage our clients to supplement their treatment here with participation in Moderation Management (MM) which can be accessed via the MM website www.moderation.org. Other evidence-based self-help options include SMART Recovery, which uses cognitive-behavioral techniques similar to those in our program. MM is a free self-help program for people concerned about their drinking. It is designed to assist individuals with mild to moderate alcohol problems achieve either moderation or abstinence. Currently, MM is the only self-help program that supports moderate drinking goals. MM encourages people who are concerned about their drinking to take action to cut back or quit drinking before drinking problems become severe. MM provides information about alcohol, moderate drinking guidelines and limits, drink monitoring exercises, goal setting techniques, and self-management strategies. There are only two dozen or so MM meetings nationwide, but there are MM internet forums and chatrooms.
How to Get Started
If you are concerned about your drinking and want professional help in deciding what to do, contact us today to schedule a private consultation with Dr. Washton. Just fill out the Contact Us form on this page or call our office in Manhattan (212) 944-8444 or in Princeton, NJ (609) 497-0433.
