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on straight and sometimes I do dumb stuff. I'm more aware of it now,
but I still do it. My new friends are real friends, not drinking buddies.
I don't know. I looked at some studies on the Internet and it looks like
I have a pretty good chance of becoming an alcoholic. I like to drink.
It makes me feel strong. I'm in a profession where there's a lot of heavy
drinking and sometimes you do it with superiors and clients to fit
in and for advancement but, yes, I know I'm better. I just hope it
keeps up.”
Albert's therapist said, “Albert has a good handle on himself.
I wouldn't argue with anything he said. He has lots of potential but he
also has enough problems to make me unwilling to predict the future.
What I will say is that he works hard, is cooperative, and seems to be try-
ing to work on some longstanding issues about his perception of himself.
I think that addictions are transitory and you never know when his desire
to drink will overwhelm his desire to stay sober. The self-help group he's
in keeps close tabs on his drinking, and his new friends are helpful. I'd
caution anyone who works with substance abusers not to expect too
much from treatment. I do want to applaud the professionals he worked
with in the hospital. Even though the treatment was brief, it made a last-
ing impact on Albert to hear that he was considered an alcoholic, and it
did bring him into treatment. That's exactly what you hope for with seri-
ous alcoholics who are in denial.”
In this chapter on treatment, three types of work-related problems fre-
quently seen in Employee Assistance Programs and by other mental
health professionals working with job unhappiness and anxiety, burnout,
and substance abuse are discussed. Evidence-based practice (EBP) and
substance abuse research findings are reported that suggest the effective-
ness of certain types of treatment, particularly very brief treatment with
high-risk abusers. Promising research on natural recovery and self-help
groups suggests that treatment effectiveness may be consistently positive
with these two approaches. Research issues are discussed that make the
development of best evidence on the efficacy of all forms of treatment
of substance abuse questionable, and the suggestion is made that before
we can develop best evidence, more effective studies must take
place that include adequate research designs and controls. A case study
is provided that demonstrates the use of EBP with substance-abusing
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