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“ Thinking Out of the Box ” : Clinical and Practical Aspects of Moderate Drinking Strategies. Arnold M. Washton, Ph.D. & Scott Stern, LCSW, CADAC RECOVERY OPTIONS New York, NY & Princeton, NJ. Topics. Prefatory remarks Why moderation?

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Thinking Out of the Box”:Clinical and Practical Aspects of Moderate Drinking Strategies

Arnold M. Washton, Ph.D. &

Scott Stern, LCSW, CADAC

RECOVERY OPTIONS

New York, NY & Princeton, NJ


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Topics

  • Prefatory remarks

  • Why moderation?

  • How to enhance treatment attraction, engagement, retention

  • Alcohol’s effects

  • How much drinking is “too much”?

  • Research on moderation

  • Clinical assessment & goal selection

  • Moderation strategies & skills


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To download copies of todays’ slides:

  • www.ModerateDrinkingOptions.com

  • Downloads & Links page

  • NASW Conference: “Moderate Drinking Strategies”



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Websites

  • Niaaa.nih.gov

  • Moderation.org

  • ModerateDrinking.com

  • SmartRecovery.org

  • RecoveryOptions.us

  • ModerateDrinkingOptions.com




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Arnold M. Washton, Ph.D.

Joan E. Zweben, Ph.D.

Guilford, 2006


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How I arrived at using moderate drinking strategies in my clinical practice

  • In 1975, started treating IV heroin addicts in an East Harlem clinic. Most continued drinking after stopping heroin.

  • Starting in early 1980s, started treating cocaine addicts who often did not want to stop drinking except after multiple alcohol-related relapses

  • Since the beginning, treated countless primary alcoholics who did not want to start with abstinence. Many refused treatment or dropped out prematurely.


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How I got here clinical practice

  • Regrettably, I too often took the stance of “come back when you’re motivated and ready to stop”

  • For past 10+ years, I’ve offered moderation training as an initial engagement strategy for patients with serious alcohol problems and as a primary treatment strategy for many with less severe problems

  • Since closing my outpatient clinic in 1998, I’ve been in full time private practice treating high-functioning adults with alcohol and drug problems


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How I got here clinical practice

  • Private practice affords me the flexibility to treat patients without being constrained by agency policies and politics

  • Patients seeking help with moderation or abstinence often find me through my website moderatedrinkingoptions.com and recoveryoptions.us


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How I got here clinical practice

  • Entering the field as a psychologist trained in both cognitive-behavioral and psychodynamic therapies, I gravitated naturally toward more individualized, integrative, non-dogmatic approaches

  • I place great value on establishing a good working therapeutic relationship with my patients, seeing this as the primary vehicle for facilitating positive change


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Prefatory Statement clinical practice

  • Total abstinence is without question the safest goal for anyone who has developed an alcohol problem

  • This is especially true for anyone who has developed a serious problem that qualifies for (or approximates) a diagnosis of Alcohol Dependence

  • Moderate drinking is generally NOT a realistic or appropriate goal for alcoholics


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Prefatory Statement clinical practice

I am not here as a proponent of any singular approach, philosophy, model, or program:

  • Harm Reduction

  • Moderation Management

  • Disease Model

  • 12-Step

  • CBT/Social Learning

  • Psychodynamic (Self-Medication)


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Prefatory Statement clinical practice

  • I support and utilize any and ALL of these, depending on what makes the most sense for a given patient and most importantly what seems to work best!


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