IV. Treatment

Who is qualified to diagnose and treat alcoholism?

What is AA, and how does it work?

What is ASAM, and what are the criteria for placement in a particular program?


Who is qualified to diagnose and treat alcoholism?

Many clinicians of various educational backgrounds are qualified to diagnose and treat alcoholism. The choice of the type of practitioner will depend on the need for therapy, medication, or both. Your internist or family practice doctor can diagnose and treat alcoholism to a limited degree, as can a nurse practitioner. This usually entails managing the medical consequences of heavy drinking, but may also include prescribing medication specifically indicated for alcoholism (see Questions 47-52). They will also refer you to a mental health specialist for a more in-depth evaluation. Some internists have specialty certification through the ASAM. Psychiatrists can also receive ASAM certification but often receive advanced fellowship training in addiction psychiatry through the American Board of Psychiatry and Neurology. Internists and psychiatrists typically oversee programs and evaluate and treat symptoms of withdrawal and any underlying medical and psychiatric problems that occur along with the alcohol problem.

The choke of the type of practitioner will depend on the need for therapy, medication, or both.

American Board of Psychiatry and Neurology the governing body that oversees clinical standards for both psychiatrists and neurologists and the various subspecialty fellowships such as child and adolescent psychiatry and addiction psychiatry.

Psychologists, licensed clinical social workers who have specialized in addiction treatment, or other therapists who have received certification through one of a variety of programs depending on the discipline and the particular state in which they work provide most types of psychotherapies — individual, family, and group.

Certification as an addiction counselor usually requires a minimum number of hours of supervised work (typically in the thousands). Addiction counselors may have only a high school diploma before they complete their supervised clinical work, but more typically, they have either an associate's degree or a bachelor's degree. Occasionally, they can also have a masters' degree, but these degrees are more often associated with licensed clinical social workers. Addiction counselors are not authorized to specifically diagnose, but they do participate in evaluations and treatment. Mental health specialists who can evaluate for and treat alcoholism include the following:

• Social workers

• Psychologists

• Psychiatric clinical nurse specialists or nurse practitioners

• Psychiatrists

Social Workers

Social workers provide a full range of mental health services, including assessment, diagnosis, and treatment. They have completed undergraduate work in social work or other fields, followed by postgraduate education to obtain a Master's of Social Work or a doctorate degree. A Master's of Social Work is required in order to practice as a clinical social worker or to provide therapy. Most states require practicing social workers to be licensed, certified, or registered. Postgraduate education includes 2 years with courses in social welfare, psychology, family systems, child development, diagnosis, and child and older person abuse/neglect. During the 2 years of coursework, social work students participate in internships that are concordant with their interest. After completion of the master's program, direct clinical supervision is usually required for a period of time to apply for a license, which may vary from state to state.

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