J Korean Neuropsychiatr Assoc.  2014 Jul;53(4):221-227.

Korean Addiction Treatment Guidelines (III) : Psychosocial Treatment of Alcohol Use Disorder

• Oh SH
• Han CW
• Seo JS
• Joe KH
• Lee HK
• Yoon HG
• Choi SW
• Kim HS
• Lee BH
• Lee KS

Abstract

OBJECTIVES
The aim of this study is to develop guidelines for psychosocial treatment of alcohol use disorder.
METHODS
According to the ADAPTE manual, the Korean alcohol use disorder treatment guidelines were developed by the guideline development committee. Recommendations from foreign guidelines were evaluated regarding the applicability and acceptability to domestic circumstances. In addition, a survey from experts was conducted, along with a review of Korean literature. By these means, recommendations of psychosocial treatment for alcohol use disorder were established.
RESULTS
The main findings of the survey were as follows : 1) Although Group therapy was not recommended by foreign clinical guidelines, it was considered as a first-line treatment by Korean experts. 2) Among many psychosocial treatment programs, cognitive behavior therapy (CBT), coping skills training, 12-step facilitation, and Group therapy were commonly used programs in Korea. Finally, the following treatment methods were selected for recommendations : Group therapy, motivational enhancement treatment, CBT, behavioral self-management, alcoholic anonymous, 12-step facilitation, psychodynamic psychotherapy, psychoeducational intervention, continuous case management, and community residential rehabilitation program.
CONCLUSION
Just as in treatment of chronic diseases such as hypertension, continuity is important for management of alcohol use disorder. Therefore, not only pharmacological treatment but also psychosocial treatment should be provided comprehensively after treatment of acute withdrawal symptoms.

Keyword

Addiction; Alcohol use disorder; Guidelines; Psychosocial treatment

MeSH Terms

Adaptation, Psychological
Alcoholics
Anonyms and Pseudonyms
Case Management
Chronic Disease
Cognitive Therapy
Humans
Hypertension
Korea
Psychotherapy, Group
Psychotherapy, Psychodynamic
Rehabilitation
Self Care
Substance Withdrawal Syndrome

Reference

1. World Health Organization. Global status report on alcohol and health. Geneva: WHO Press;2011.

2. Seoul National University College of Medicine. The Epidemiological Survey of Psychiatric illnesses in Korea. Seoul: Ministry of Health & Welfare, Research Service Study Report;2011.

3. The National Mental Health Commission. The Central Mental Health Supporting Committee Report. . Seoul: Korean Institute for Health and Social Affairs Press;2009.

4. Lee HK, Lee MS, Ki SW, Choi SW, Joe KH, Park A, et al. Developing therapeutic framework for treatment of Alcoholism: focused on Seoul Alcohol Action plan. J Korean Assoc Soc Psychiatry. 2007; 12:57–67.

5. Ki SW. Recent psychosocial therapeutic approach on alcohol dependence. J Korean Neuropsychiatr Assoc. 2004; 43:646–651.

6. Holder H, Longabaugh R, Miller WR, Rubonis AV. The cost effectiveness of treatment for alcoholism: a first approximation. J Stud Alcohol. 1991; 52:517–540.

7. Kim SG, Shin YC, Lee HK, Lee TG, Gee SW, Lee SG, et al. Addiction Treatment Guidelines Series. Seoul: Korean academy of addiction psychiatry, Ministry of Health & Welfare Alcohol Project Supporting Committee Research Paper;2011.

8. Field MJ, Lohr KN. Clinical Practice Guidelines: Directions for a New Program. Washington, DC: National Academy Press;1990.

9. Grilli R, Magrini N, Penna A, Mura G, Liberati A. Practice guidelines developed by specialty societies: the need for a critical appraisal. Lancet. 2000; 355:103–106.

10. Cpg.or.kr [homepage on the Internet]. Clinical practice guideline for stroke. Seoul: Korean Guideline Clearinghouse;updated 2013 February 22. cited 2009 October 30. Available from: http://cpg.or.kr.

11. Cpg.or.kr [homepage on the Internet]. Evidence-based medicine guideline for posttraumatic stress disorder. Seoul: Korean Guideline Clearinghouse;cited 2008 November 18. Available from: http://cpg.or.kr.

12. Kim SY, Kim NS, Shin SS, Kim DW, Ji SM, Lee SJ. ADAPTE: Manual for guildeline adaptation version 1.0. Seoul: National Clinical Research Coordination Center;2009.

13. Guidance.nice.org.uk [homepage on the Internet]. Alcohol use disorders: diagnosis, assessment, and management of harmful drinking and alcohol dependence. London: National Institute for Health and Care Excellence;cited 2011 February 1. Available from: http://guidance.nice.org.uk.

14. Haber P, Lintzeris N, Proud E, Lopatko O. Guidelines for the treatment of alcohol problems. Department of Health and Ageing Australia press;2009.

15. Work Group on Substance Use Disorders. Kleber HD, Weiss RD, Anton RF, Rounsaville BJ, George TP, et al. Treatment of patients with substance use disorders, second edition. American Psychiatic Association. Am J Psychiatry. 2006; 163:8 Suppl. 5–82.

16. Brouwers MC, Browman GP, Burgers JS, Cluzeau F, Davis D, Feder G, et al. The AGREE instrument. Ontario: The AGREE Next Steps Consortium;2009.

17. Lee BH, Kim HS, Seo JS, Shin YC, Ki SW, Kim SG, et al. Korean Addiction Treatment Guidelines Series (I): Development of Korean Guidelines for the Treatment of Alcohol Use Disorder. J Korean Neuropsychiatr Assoc. 2013; 52:263–271.

18. Shekelle PG, Woolf SH, Eccles M, Grimshaw J. Clinical guidelines: developing guidelines. BMJ. 1999; 318:593–596.

19. Sachs GS, Printz DJ, Kahn DA, Carpenter D, Docherty JP. The Expert Consensus Guideline Series: Medication Treatment of Bipolar Disorder 2000. Postgrad Med. 2000; Spec No:1–104.

20. Scheidlinger S. The group psychotherapy movement at the millennium: some historical perspectives. Int J Group Psychother. 2000; 50:315–339.

21. Leshner AI. Introduction to the special issue: The National Institute on Drug Abuse's (NIDA's) Drug Abuse Treatment Outcome Study (DATOS). Psychol Addict Behav. 1997; 11:211–215.

22. Noh JW, Lee KS. Treatment adherence after discharge of alcohol dependent patients. J Korean Acad Addict Psychiatry. 2013; 17:68–73.

23. Ferrell WL, Galassi JP. Assertion training and human relations training in the treatment of chronic alcoholics. Int J Addict. 1981; 16:959–968.

24. Larimer ME, Palmer RS, Marlatt GA. Relapse prevention. An overview of Marlatt's cognitive-behavioral model. Alcohol Res Health. 1999; 23:151–160.

25. O'Farrell TJ, Fals-Stewart W. Behavioral couples therapy for alcoholism and drug abuse. J Subst Abuse Treat. 2000; 18:51–54.

26. Hettema J, Steele J, Miller WR. Motivational interviewing. Annu Rev Clin Psychol. 2005; 1:91–111.

27. Vasilaki EI, Hosier SG, Cox WM. The efficacy of motivational interviewing as a brief intervention for excessive drinking: a meta-analytic review. Alcohol Alcohol. 2006; 41:328–335.

28. UKATT Research Team. Effectiveness of treatment for alcohol problems: findings of the randomised UK alcohol treatment trial (UKATT). BMJ. 2005; 331:541.

29. Ambrogne JA. Reduced-risk drinking as a treatment goal: what clinicians need to know. J Subst Abuse Treat. 2002; 22:45–53.

30. Walters GD. Behavioral self-control training for problem drinkers: a meta-analysis of randomized control studies. Behav Ther. 2000; 31:135–149.

31. Hodgins DC, Leigh G, Milne R, Gerrish R. Drinking goal selection in behavioral self-management treatment of chronic alcoholics. Addict Behav. 1997; 22:247–255.

32. Lee KS. Treatment of alcohol use disorder. J Korean Diabetes. 2012; 13:85–90.