Effective help with alcohol abuse and dependence is hard to come by, despite large numbers of treatment programs.

The problem is that a majority of these programs have grown from a single - and ineffective - male model whose business success has long overridden client needs despite dismal outcomes. 

The result, for women, is that most options omit a number of the research based components that include:

1.      Early detection, including screening and brief interventions;

2.    Comprehensive assessment and individualized treatment plan;

3.    Care management;

4.    Individually delivered, proven professional interventions;

5.    Contracting with patients;

6.    Social skills training;

7.    Medications;

8.    Specialized services for medical, psychiatric, employment or family problems;

9.    Continuing care;

10.    Strong bond with therapist or counselor;

11.    Longer duration;

12.    Participation in support groups (NOT AA or Alanon);

13.    Strong patient motivation.

Additionally, virtually none of the factors have been modified to address the differing needs of women.

An example may help to clarify this point.

Item #12, "Participation in support groups," is almost universally interpreted to mean Alcoholics Anonymous (AA), a group that is helpful to a very small minority of male alcoholics (less than 2% of those who try it).

Women are better served when "support group" is taken to mean participation in an activity which is more rewarding than drinking whether that happens to be the League of Women Voters, university classes, weight training at the gym, or volunteering at some landmark or park.

Many of the other rarely-applied recommendations do have short term value. The use of Naltrexone to combat cravings while other therapeutic and recreational activities are explored is an example.

Comprehensive assessments that focus on strengths and interests rather than funding labels are another. So is the connection with a competent counselor whose role is often that of coach, educator, guide, and trainer all rolled into one.

It's interesting that the above referenced list placed the most important point, motivation, last. In the long run nothing else matters and the other twelve points are merely means of creating, reinforcing, and extending the interest in change.

For women, this is usually going to be found in nurturing a sense of empowerment since alcohol use is so frequently rooted in feelings of helplessness and hopelessness - a feeling that may prompt one to sign up for "powerlessness," a belief in which is the single greatest predictor of relapse. Interesting that traditional treatment programs begin with clients coerced into believing the one thing that is most apt to cause them to fail.

In reality, effective strategies for ending women's alcohol abuse and dependence are rooted in doing rather than talking - belief in one's self, improved coping and assertiveness skills, physical activity, good nutrition, and the other attributes that add up to a life of one's own.

The trick is to avoid the traps and snares of "disease" models, life long "recovery," and the unending focus on alcohol.

Remember: "Get a grip; Get a life; Get over it."