Impatient rehab, the cure for alcoholism does not exist, as in any another one case of chemical dependence. What it exists is treatment. In the great majority of the cases, the proper patient does not obtain to perceive how much he is involved with the drink, tending to deny the same use or its dependence for the same one. In these cases, the treatment can be started helping the patient to recognize its problem and the necessity to treat itself and to try to abstain it alcohol. The indication of internment, at least as initial phase of detoxification, usually to be the rule.

Many evidences exist of that the cognitifs mannering treatments that try the improvement of the self-control and the social abilities lead consistently to the reduction of alcoholism. It enters the indicated forms of treatment more, are the programs based on the 12 steps (Alcoholic Anónimos), based on the acceptance of the illness, to face and to prevent the fallen again one. Studies also indicate that the support of the family in the process of treatment of the alcoholic one contributes with the improvement of the results. The actuais recommendations for treatment of alcoholism, involve two stages:

Detoxification

Generally carried through per some days under medical supervision, it allows to fight the acute effect of the withdrawal of the alcohol. Given the highest fallen again indices of, however, alcoholism is not illness to be treated exclusively in the scope of the conventional medicine.


Whitewashing

After controlled the acute symptoms of the crisis of abstinence, either for way of internment or through treatment clinic, the patients must be directed for whitewashing programs, whose objectivo is to help them to live it without alcohol in the sanguineous circulation, as the groups of auto-aid (A.A). She is necessary to remember that the fallen again ones are common in the alcoholic patients.
Alcoholism is an incurable illness, of fatal determination and gradual until exactly in periods of abstinence, however, treatments exist to interrupt the growth of the illness, as we will see to follow.


Psychosocial treatment

The described psycotherapies more ahead have been used in the treatment of the upheavals caused for the use of the alcohol. Some authors had made revisions of the effectiveness of the some psycotherapies for such upheavals. This topic makes mannering revisions of the results in literature on cognitivas mannering therapies, therapies, interpersonal psychodynamic therapies/, brief interventions, conjugal and familiar therapy, therapy of group, aftercare and groups of auto-aid.


Cognitivas mannering therapies

Many evidences exist of that the cognitivos mannering treatments that have as objective the improvement of the self-control and the social abilities lead consistently to the reduction of alcoholism. Strategies of self-control include establishment of goals, auto-monitoring, functional analysis of the antecedents of alcoholism and possibilities of learning of alternatives to faceconflicting situations.

The trainings of the social capacities are concentrated in developing abilities to form and to keep more steady interpersonal relations, positividade and refuse to accept drunk. Studies, had told that the mannering interventions for treatment of stress had been effective in six of the ten reviewed cases. It was discovered that patient interned that the hints had received treatment from exposition citizens the trainings of the support abilities, better they had resulted that those that had received only the treatment standard while interned. Interventions in cognitive therapy concentrated in identifying and modifying badly adaptativos thoughts and that they do not include a component mannering have been so effective how much the cognitive mannering treatments.

The trainings of the self-control consist of cognitivas and mannering strategies, also auto-monitoring, establishment of goals, reward for attainment of goals, functional analysis of propitious situations to drink and learning of the alternative abilities to face the problem with drinks. Although some studies of treinos of mannering self-control have enclosed controlled alcoholism, as well as abstinence, as objectivo of the treatment, the mannering techniques of self-control must in the long run be used with the explicit objectivo of abstinence.

In some studies, the increase of the answers to face the problem or “auto-effectiveness”, in the end of the treatment had gotten better resulted with the drink during the accompaniment. The individuals that tell more frequent use of cognitivas or mannering strategies with intention to decide or to dominate the problem typically (“to face for approach”) better have resulted that those that depend to be distant of the situations of high risk (“to face to prevent”).


Mannering therapies

The individual mannering therapy and the conjugal one have demonstrated efectividade for patients with upheavals caused for the use of the alcohol. The studied boarding more of the treatment of patients with upheavals caused for the use of the alcohol is the boarding of the reinforcement of the community, that uses mannering principles e, generally, includes therapy, trainings to find work, aconselhamento joint directed free the social and recreativas activities of alcohol. Using random assignment for reinforcement of the community or standardized hospital treatments, it was observed that the patients in the group of reinforcement of the community, drank little, passed little days far from house, worked more days and less were institutionalized during a accompaniment of 24 months.

As a controlled study comparing the boarding of reinforcement of the community, plus a mannering program of allegiance to the treatment and treatment regular clinic, it showed that the patients dealt with reinforcement of the community had substantially better left in all the measures results that those in other conditions of treatment.


Interpersonal psychodynamic therapies

They had concluded that it had few empirical evidences of controlled studies of that the psycotherapy guided for insight or aconselhamento is effective treatments for alcoholism. The individual psycotherapy produced better resulted that a condition of control in two of the eight reviewed studies, and the guided therapy of group psicodinamicamente produced better resulted in two of eleven studies. Generic boardings of aconselhamento (characterized as primarily directivas and of support) had produced better resulted that the controls in one of eight reviewed studies. Existing studies on this modality can be limited by its boardings short-term.

Conjugal and familiar therapy

The state of the relationship of the patient with familiar or other equally significant people can be critical factor in the surrounding post-cure for patients who are married or that they live with the family.
Two other studies had shown that the patients who had received conjugal therapy mannering had started to have better resulted with regard to alcoholism that those that had not had it after one year of accompaniment. Studies had also indicated that the envolvement of the spouse in the treatment precociously takes to the improvement of the conjugal results and the use of the alcohol in the period post-cure, that the patients in joint therapy have minor probability to abandon the treatment, and that the therapy with intention to improve marriage as a whole seems to rigidly function better that the intent therapy of couples in the related problems the alcohol (therapy with envolvement minimum of the only intent spouse or in the alcohol).


Brief interventions

• The brief interventions, in general, are offered by one the three sessions and include a shortened evaluation of the gravity of alcoholism and related problems and motivacional supply of feedback, beyond aconselhamento. In eight of the nine controlled experiences of treatment and magazines., the brief interventions had demonstrated to be effective, even so told resulted negative.

• Revisions had concluded that brief interventions are typically more effective (in terms of use of the alcohol general health or social functioning), many times have comparable effectiveness to the one of more intense traditional programs and the longest stated period and increase the efectividade of the posterior treatment. Exactly the interventions that are very brief (that is, of some hours) can have some positive effect. Brief interventions are used typically (and they have more success) for afectados patients less seriously and that they have not received previous treatment for an upheaval with the alcohol. More research is necessary to determine which patients excellently is served by the act of receiving of a brief intervention. This is the prision of impatient rehab.