酒精依赖治疗方法

酒精依赖治疗 酒精依赖的心理疗法述评 庞颖 (吉林大学哲学社会学院应用心理学专业，长春 130012) 摘要 酒精依赖及其相关问题在当今社会已经成为仅次于血管疾病，肿瘤的第三大公共卫生问题。已成为中西方心理学界和精神研究界比较热门的研究课题，但就国情来看，国内对此还未给予足够的重视。本文将介绍酒精依赖的相关定义，现形式及多种心理治疗方法。有效的采取措施以预防酒精依赖，酒精依赖研究今后应立足于心理疗法的相关研究，弥补不足。提出更有效地治疗方法并对临床实证研究方面深入探索。 关键词 酒精依赖 酒依赖综合症 心理治疗 1 引言 早在20世纪30年代，人们就开始认识到酒精依赖实际是一种疾病，而非由于饮酒者道德沦丧或意志薄弱所致，酒精依赖是仅存于心血管疾病和肿瘤而居于第三位的公共卫生问题。酒精依赖是由于饮酒所致的对酒渴求的一种心理状态，可连续或周期性出现，这种渴望常很强烈。酒精依赖综合症首先由Yictor和Adams(1953)所描述，是指在完全或部分停止饮酒后所出现的一组症状，有震颤，一过性幻觉，癫痫发作和谵妄等。1977年，世界卫生组织建议 ?用酒精依赖综合症代替酒依赖。 酒精依赖者的主要表现是对饮酒的失控和耐受性，对酒精有神经依赖和躯体依赖，存在戒断综合症，早期会出现焦虑和抑郁情绪。他们对社会和家庭不负责任，生理，心理和行为发生改变，以神经，精神障碍为主，伴有机体其他脏器损害。酒依赖主要可视为个体压抑功能的释放，使压抑的各种心理冲突得以表现。既而引发多种心理障碍，如:幻觉症，痉挛发作，震颤谵妄，嫉妒妄想，痴呆等。科学家对酒精依赖者进行人格测试，发现他们在社会适应力和人际交往方面有着某些共同特征，因此对酒精依赖病人的心理治疗不仅有着深远的社 ?会意义，还会对异常心理学的研究做出贡献。 心理治疗也称精神治疗，是有别于生物治疗，化学治疗和物理治疗的一整套治疗方法。 ?郑晓边著.心理变态与健康.合肥:安徽人民出版社.2003 ,P129 ?梁宝勇主编.变态心理学.天津:南开大学出版社.2005,P163-P172 loan management (post) review: 1, approval criteria have been implemented; 2, the contract is correct; 3, in line with the contract, payment; 4, no other major cases against loan security;、Reviewed by: date of record form 9: qilu bank borrowing by single years of maximum amount a maximum no-loan borrowers: borrowers: ... Borrower name number, line of credit expiry date year month day to year month day maximum number of years in the loan contract are the top line opened, the borrowed and requested your bank opened credit lines above, is hereby requested. Borrower signature: date agreed to open credit lines. Customer Manager signature: date agreed to open credit lines. Loan review signature: date line cancellation-I did not use the loan amount, your bank credit lines to be cancelled. -Credit loan principal repayment, your bank credit lines to be cancelled. Borrower signature: date-unused credit lines, agree to write off loans. -Credit loan principal repayment, agree to write off loans. Customer Manager signature: date case, agree to write off loans. Loan review signature: date of record form 16: qilu self credit for credit card cancellation application form name of borrower ID number and credit limit expiration date year month day to year month day year contract number self-service card-I do not use credit, your bank credit lines to be cancelled. -Credit loan principal repayment, your bank credit lines to be cancelled. Borrower signature: date-unused credit lines, agree to write off loans. -Credit loan principal repayment, agree to write off loans. Customer Manager signature: 从广义上讲，凡是运用心理学的基本原则和技巧，通过言语，表情，态度，姿势，行为以及周围环境和生活条件的改善，去影响，改变患者的感受，认知，情绪和行为等。从而达到改善心理状态，行为方式以及由此引起的各种躯体症状，都可以认为是心理治疗。狭义上讲，心理治疗则是指心理医生或心理咨询师在一定得心理学理论体系指导下，所实施的理论治疗方法与技术。心理治疗的形式是多种多样，根据心理治疗的对象可以将其分为个别心理治疗， ?集体心理治疗以及家庭心理治疗。 2(酒精依赖的个别心理治疗 个别心理治疗的理论和方法起源于精神分析方法。弗洛伊德发现，在一个受过专业训练的治疗者与酒精依赖的病人之间建立起来的一种职业上的联系可以减轻或改善疾病的症状和行为的方式。现今的各种心理治疗都是以个别心理治疗为基础的，方式是治疗者和患者之间的面对面大的交谈。 个别心理治疗除精神分析法以外，还包括荣格的分析心理学，格式塔心理治疗，语义治疗，行为治疗，认知治疗和人本主义心理治疗都可适用于个别心理治疗，下面介绍几种常用的个别心理治疗的具体方法。 2.1精神分析疗法 以弗洛伊德首创的精神分析理论为指导，探讨病人的深层心理，识别潜意识的欲望和动机，解释病理与症状的心理意义，协助病人对本我的剖析，解除自我的过分防御，调节超我的适当管制，善用病人与治疗者的移情关系，来改善病人的人际关系，调整心理结构，消除 ?内心症结，促进人格的成熟，提高适应能力。 在弗洛伊德之后，精神分析疗法被后来者逐步发展完善，至今在酒依赖心理治疗领域中得到广泛的应用。为了让患者在接受精神分析治疗时能够以积极的态度参与进来，现对精神分析治疗过程进行一下大致介绍。精神分析治疗过程通常分为四个阶段: (1)开始阶段。首先是要了解患者在酒精戒断时遇到的问题，确认患者是否适合用精神分析治疗。确认后，咨访双方.应就治疗规则、治疗阶段、双方责任取得共识。接下来，治疗者开始由浅入深了解患者产生酒精依赖心理冲突的根源。 (2)移情发展阶段。随着治疗的逐步进行，酒精依赖患者会出现对治疗者的移情。移情 ?张伯源主编.变态心理学.北京:北京大学出版社，2005.6,P262-P263 ?姜佐宁主编.药物成瘾的临床与治疗.北京:人民卫生出版社.1997 loan management (post) review: 1, approval criteria have been implemented; 2, the contract is correct; 3, in line with the contract, payment; 4, no other major cases against loan security;、Reviewed by: date of record form 9: qilu bank borrowing by single years of maximum amount a maximum no-loan borrowers: borrowers: ... Borrower name number, line of credit expiry date year month day to year month day maximum number of years in the loan contract are the top line opened, the borrowed and requested your bank opened credit lines above, is hereby requested. Borrower signature: date agreed to open credit lines. Customer Manager signature: date agreed to open credit lines. Loan review signature: date line cancellation-I did not use the loan amount, your bank credit lines to be cancelled. -Credit loan principal repayment, your bank credit lines to be cancelled. Borrower signature: date-unused credit lines, agree to write off loans. -Credit loan principal repayment, agree to write off loans. Customer Manager signature: date case, agree to write off loans. Loan review signature: date of record form 16: qilu self credit for credit card cancellation application form name of borrower ID number and credit limit expiration date year month day to year month day year contract number self-service card-I do not use credit, your bank credit lines to be cancelled. -Credit loan principal repayment, your bank credit lines to be cancelled. Borrower signature: date-unused credit lines, agree to write off loans. -Credit loan principal repayment, agree to write off loans. Customer Manager signature: 是患者将自己对过去关于酒精依赖戒断过程中发生的重要人物,事件投射到治疗者身上。治疗者依据求助者的投射对其进行体验、理解并告知求助者。 (3)修通阶段。结合患者提供的各种材料和移情表现，运用解释为主的技术，向患者揭示其内心的无意识欲望和无意识冲突与自身表现出的症状的关系，获得患者的理解和领悟。在修通的过程中会遇到阻抗，这是治疗过程中自然和必要的反映，只有将这个过程坚持下去才会逐渐获得疗效。 (4)移情解决阶段。对求助者的主要无意识冲突已经修通的情况下，治疗者对结束治疗确定一个大致的日期。在这个阶段中，患者可能会在移情上出现反复，治疗者需要继续采取解释技术解决患者遗留的问题，使之能够面对现实。当患者能够解决移情并做好结束的准备时，治疗就可以结束了。 2.2行为疗法 (1)系统脱敏疗法 (Systematic Desensitization)又称交互抑制法或缓慢暴露法，是沃尔普在五十年代末期发展起来的一种行为疗法。利用这种方法主要是诱导患者缓慢地暴露出导致酒精依赖症状的情境，并通过心理的放松状态来对抗这种焦情绪，现被广泛运用于恐怖症和强迫症。近年来系统脱敏法对戒除酒瘾有着明显的成效，沃尔普认为，人和动物类似，也是由条件反射引起的，根据这一原理，在心理治疗时便应从能引起个体较低程度的酒精戒断反应开始进行治疗。一旦某个刺激不会再引起求治者反应时，施治者便可向处于放松状态的求治者呈现另一个比前一刺激略强一点的刺激。如果一个刺激所引起的酒精戒断症状反应在求治者所能忍受的范围之内，经过多次反复的呈现，他便不再会对该刺激感到焦虑和恐怖，治疗目标也就达到了。这就是系统脱敏疗法的治疗原理。 酒精依赖的病人经过多次刺激呈现和神经活动的结合，通过循序渐进地减少患者的酒精依赖水平，结合奖励进行强化，在心理医生的监督和指导下，达到的戒断心瘾的目的，具有痛苦小，成功率高的特点。 (2)厌恶疗法(aversion therapy)又称一种较常用的行为治疗技术，其做法为将欲戒除的目标行为(或症状)与某种不愉快的或惩罚性的刺激结合起来，通过厌恶性条件作用，达到使患者最终因感到厌恶而戒除或减少目标行为的目的。它是应用惩罚的厌恶性刺激，即通过直接或间接想象，以消除或减少某种适应不良行为的方法。厌恶疗法的特点是，治疗期较短，效果较好。 厌恶疗法常用于治疗酒精依赖病人，所以在这里将详细的进行介绍。通过对患者loan management (post) review: 1, approval criteria have been implemented; 2, the contract is correct; 3, in line with the contract, payment; 4, no other major cases against loan security;、Reviewed by: date of record form 9: qilu bank borrowing by single years of maximum amount a maximum no-loan borrowers: borrowers: ... Borrower name number, line of credit expiry date year month day to year month day maximum number of years in the loan contract are the top line opened, the borrowed and requested your bank opened credit lines above, is hereby requested. Borrower signature: date agreed to open credit lines. Customer Manager signature: date agreed to open credit lines. Loan review signature: date line cancellation-I did not use the loan amount, your bank credit lines to be cancelled. -Credit loan principal repayment, your bank credit lines to be cancelled. Borrower signature: date-unused credit lines, agree to write off loans. -Credit loan principal repayment, agree to write off loans. Customer Manager signature: date case, agree to write off loans. Loan review signature: date of record form 16: qilu self credit for credit card cancellation application form name of borrower ID number and credit limit expiration date year month day to year month day year contract number self-service card-I do not use credit, your bank credit lines to be cancelled. -Credit loan principal repayment, your bank credit lines to be cancelled. Borrower signature: date-unused credit lines, agree to write off loans. -Credit loan principal repayment, agree to write off loans. Customer Manager signature: 的条件训练，使其形成一种新的条件行为，以此消除患者的酒精依赖行为。在治疗时，厌恶性刺激应该达到足够强度。通过刺激确能使患者产生痛苦或厌恶性反应，治疗持续的时间应为直到依赖行为消失为止。 延误治疗的形式可分为:第一种是电击厌恶疗法，即将患者习惯性的不良行为反应与电击连在一起，一旦这一行为反应在想象中出现就予以电击。(电击强度的选择应征得求治者的同意)第二种是药物厌恶疗法，即在患者迫切需要饮酒时，让其服用呕吐药，产生呕吐反应，从而使该饮酒行为逐渐消失。药物厌恶疗法其缺点是耗时太长，且易弄脏环境。第三种是想象厌恶疗法，即将施治者口头描述的某些厌恶情境与求治者想象中的饮酒行为联系在一起，从而产生厌恶反应，以达到治疗目的。此疗法操作简便，适应性广。 (3)行为塑造法(shaping)。这是根据斯金纳的操作条件反射原理设计出来的，目的在于通过强化(即奖励)而造成某种期望出现的良好行为的一项行为治疗技术。一般采用逐步减少饮酒量，并在出现戒断反应时给予支持和奖励(即强化)，促使病人较快的克服戒酒阶段的阶段反应。可以将病人每次的饮酒量做成图表状，这样做是对行为改善的一种强大推动力，根据图表所示的进展，当超过一定的指标时即给予表扬或奖励。此外，还可采用让患者得到喜爱的食物或娱乐等办法，通过这种方式来塑造新的行为，以取代饮酒行为。 为了使治疗效果得以保持和巩固，在应用这一治疗方法时，需要特别注意如何帮助患者把在特定治疗情境中学会的行为转换到家庭或工作的日常生活现实环境中来。这样可以保证病人在很长一段时间不再酒精成瘾，既而导致戒断综合症症状减轻，治疗效果明显。 (4)松弛反应训练(relaxtion training),这是一种通过自我调整训练，由身体放松进而导致整个身心放松，以对抗由于心理应激而引起交感神经兴奋的紧张反应。一般的松弛反应训练方法，使被试者学会交替收缩或放松自己的骨骼肌群，同时能体验到自身肌肉的紧张和松弛的程度以及有意识地去感受四肢和躯体的松紧、轻重和冷暖的程度，从而取得松静的效果。 各种松弛反应训练技术在世界各国已广泛地成为人们用以增强体质，预防和治疗疾病，特别是酒精依赖等慢性病的一种有效疗法。酒精依赖戒断阶段的一系列症状会伴随着松弛反应训练而减轻，使患者可以对抗戒酒过程中紧张和焦虑情绪，结合其他的治疗方法使用，效 ?果更佳。 ?张伯源主编.变态心理学.北京:北京大学出版社，2005.6,P265-P268 loan management (post) review: 1, approval criteria have been implemented; 2, the contract is correct; 3, in line with the contract, payment; 4, no other major cases against loan security;、Reviewed by: date of record form 9: qilu bank borrowing by single years of maximum amount a maximum no-loan borrowers: borrowers: ... Borrower name number, line of credit expiry date year month day to year month day maximum number of years in the loan contract are the top line opened, the borrowed and requested your bank opened credit lines above, is hereby requested. Borrower signature: date agreed to open credit lines. Customer Manager signature: date agreed to open credit lines. Loan review signature: date line cancellation-I did not use the loan amount, your bank credit lines to be cancelled. -Credit loan principal repayment, your bank credit lines to be cancelled. Borrower signature: date-unused credit lines, agree to write off loans. -Credit loan principal repayment, agree to write off loans. Customer Manager signature: date case, agree to write off loans. Loan review signature: date of record form 16: qilu self credit for credit card cancellation application form name of borrower ID number and credit limit expiration date year month day to year month day year contract number self-service card-I do not use credit, your bank credit lines to be cancelled. -Credit loan principal repayment, your bank credit lines to be cancelled. Borrower signature: date-unused credit lines, agree to write off loans. -Credit loan principal repayment, agree to write off loans. Customer Manager signature: 2.3认知疗法 (1)合理情绪疗法(Rational,Emotive Therapy)是20世纪50年代由艾利斯在美国创立，它是认知疗法的一种，因此采用了行为治疗的一些方法，故又被称之为认知行为疗法。它的基本理论主要是ABC理论，在ABC理论模式中，A是指诱发性事件;B是指个体在遇到诱发事件之后相应而生的信念，即他对这一事件的看法、解释和评价;C是指特定情景下，个体的情绪及行为结果。ABC理论指出，诱发性事件A只是引起情绪及行为反应的间接原因，而人们对诱发性事件所持的信念、看法、理解B才是引起人的情绪及行为反应的更直接的原因。人们的情绪及行为反应与人们对事物的想法、看法有关。 该疗法是以改变患者的认知为主要治疗目标的，即改变患者的不合理信念，以合理的信念取而代之;改变不合理的思维方式，以合理的思维方式取而代之。从而达到最大限度地减少由不合理的信念给人们情绪带来的不良影响，治疗过程一般可分为心理诊断，领悟，修道和再教育等四个阶段。 在治疗酒精依赖病人过程中应该有针对性的应用该疗法，病人首先要与病人建立良好的关系，帮助病人树立信心。掌握病人所关心的所有问题，治疗者要找到病人核心的ABC。让病人了解ABC理论，强化治疗的动机。对病人不存在的不合理信念进行讨论或辩论的阶段，这是治疗的关键，消除病人对酒精的依赖性。帮助病人树立正确的合理的饮酒习惯，脱离不合理信念的困扰，在减轻酒精依赖性的同时还能让病人更健康更合理的生活。 (2)贝克认知转变疗法(Beck's cognitive therapy)这种心理疗法的理论基础是贝克的情绪障碍认知理论。其原理是个体如果不能正确处理日常生活中的问题，或对自己的自动化思维中某些错误观念不加以内省，或是过分按规则行事，无论哪种情况出现，都会造成认知歪曲，产生不良的情绪和不适应的行为问题。认知转变疗法的的主要目标在于改变患者歪曲的认知，从而改善失调的情绪与行为。 贝克认知疗法在治疗酒精依赖病人时，最重要的就是能够清楚找到病人的自动式思维，一般情况下，是很难意识到它的存在，治疗者应该详细的了解病人在不同饮酒情境中所遇到的问题，总结规律，找出共性。塑造病人新的认知结构，并检验是否可行，不断让病人巩固新的认知结构，对现实的正确认识，该疗法对于酒精依赖病人而言，尽管治疗时间长但有着显著地康复效果。 loan management (post) review: 1, approval criteria have been implemented; 2, the contract is correct; 3, in line with the contract, payment; 4, no other major cases against loan security;、Reviewed by: date of record form 9: qilu bank borrowing by single years of maximum amount a maximum no-loan borrowers: borrowers: ... Borrower name number, line of credit expiry date year month day to year month day maximum number of years in the loan contract are the top line opened, the borrowed and requested your bank opened credit lines above, is hereby requested. Borrower signature: date agreed to open credit lines. Customer Manager signature: date agreed to open credit lines. Loan review signature: date line cancellation-I did not use the loan amount, your bank credit lines to be cancelled. -Credit loan principal repayment, your bank credit lines to be cancelled. Borrower signature: date-unused credit lines, agree to write off loans. -Credit loan principal repayment, agree to write off loans. Customer Manager signature: date case, agree to write off loans. Loan review signature: date of record form 16: qilu self credit for credit card cancellation application form name of borrower ID number and credit limit expiration date year month day to year month day year contract number self-service card-I do not use credit, your bank credit lines to be cancelled. -Credit loan principal repayment, your bank credit lines to be cancelled. Borrower signature: date-unused credit lines, agree to write off loans. -Credit loan principal repayment, agree to write off loans. Customer Manager signature: 3.酒精依赖的集体心理治疗 3.1匿名者互戒协会(Alcoholics Anonymous，AA) 对于酒精依赖患者，最有效的方法莫过于AA。患者会发现在AA内感到很自在，与其他病人除饮酒问题外还可以交流其他共同感兴趣的内容。这种AA可以为患者提供不饮酒的朋友和酒吧以外的活动天地。患者可以听到其他成员的饮酒借口，从而引以为戒。他还可以为其他酒精中毒者提供帮助，从中找回以往只能在饮酒时体会到的自尊和自信。和其他国家不同，美国的AA团体中包括很多非自愿的入会者，他们的参加迫于法庭或监护官的命令。这种放弃AA自愿传统的做法可能影响它的疗效。 AA属于领悟性的集体，允许患者自由组合，互相启发和帮助，互为治疗者。在这种方式下，领导的影响较小，但要求病人的文化水平较高。病人在治疗过程中不是如此严格，在应 ? 用过程中应该是和其他治疗方法互相结合。 3.2其他集体治疗 支持性团体:在医生和护士的指导和帮助下进行，人数可以很多，可采用讲课形式。 活动性团体:强调安排娱乐和工作等各种任务和活动，如集体演出，一起劳动等，同时可以讨论自己的问题。 教育和社会团体:这是近年来逐渐兴起的一种集体心理治疗，有医生指导，还包括患者的同事，邻里及其他热心社会福利的人们，帮助患者参加社会公务活动，改善病人和社会和环境的不协调状态。 4.酒精依赖的家庭心理治疗 在家庭系统内，任何成员所表现的行为，都会受家庭内其他成员的影响，这种系统相互反应也会成为形成酒精依赖症状的原因，病人也常因配合其他成员和心理需要而被维持。所以在整个治疗过程中，应该把酒精依赖患者的家庭也作为治疗对象。通过协调家庭成员之间的人际关系，扮演角色，建立联盟，达到认同等方式，，行为模式相互影响互为连锁的效应，改进家庭心理功能，促进家庭成员的心理健运用家庭各个成员之间的个性康。 家庭治疗还包括结构疗法，行为性家庭疗法，认知家庭疗法，还包括交流疗法，心理动力学疗法等技术，家庭是由一群有特殊关系的成员所组成，有特别的感情，而且长久生活在一起，其心理治疗与一般心理治疗有所不同，需要注意一些基本的治疗原则:即淡化“理由 ?郭本禹主编.异常心理学高级. 合肥:安徽人民出版社.2007，P306 loan management (post) review: 1, approval criteria have been implemented; 2, the contract is correct; 3, in line with the contract, payment; 4, no other major cases against loan security;、Reviewed by: date of record form 9: qilu bank borrowing by single years of maximum amount a maximum no-loan borrowers: borrowers: ... Borrower name number, line of credit expiry date year month day to year month day maximum number of years in the loan contract are the top line opened, the borrowed and requested your bank opened credit lines above, is hereby requested. Borrower signature: date agreed to open credit lines. Customer Manager signature: date agreed to open credit lines. Loan review signature: date line cancellation-I did not use the loan amount, your bank credit lines to be cancelled. -Credit loan principal repayment, your bank credit lines to be cancelled. Borrower signature: date-unused credit lines, agree to write off loans. -Credit loan principal repayment, agree to write off loans. Customer Manager signature: date case, agree to write off loans. Loan review signature: date of record form 16: qilu self credit for credit card cancellation application form name of borrower ID number and credit limit expiration date year month day to year month day year contract number self-service card-I do not use credit, your bank credit lines to be cancelled. -Credit loan principal repayment, your bank credit lines to be cancelled. Borrower signature: date-unused credit lines, agree to write off loans. -Credit loan principal repayment, agree to write off loans. Customer Manager signature: 与道理”，注重“感情与行为”，这种治疗方法可以从患者的身边入手，效率高，循循渐进已 ?达到恢复健康的目的。 5存在问题与展望 近年来酒精依赖已成为值得重视和急需迫切解决的社会问题，也逐渐被研究者所关注。在研究方法上看，部分的酒精依赖障碍的还停留在描述和解释，分析层面。虽然对酒精依赖症研究起步较早，并且产生了多种治疗的手段和技术，但偏向于医学取向的研究，心理学在其中发挥的作用尚待进一步挖掘。酒精依赖的研究方法需要进一步丰富，而且由于该症状受社会文化影响较大，需加强本土化的研究。 合理的治疗方法不如强有力的预防，培养大众的健康防御意识，僵持健康的生活方式，讲究心理卫生，增强自我调控能力，及时排除各种负面的情绪培养完善和健全的人格，增强社会适应能力，对于酒精依赖病人应该鼓励他们积极参加社会活动，扩大人际交往。 从环节上看，对酒精依赖的发生和发展机制研究相对成熟，而对于临床治疗和预防还是相对薄弱，特别是有针对性的心理治疗。由于心理治疗的发展受到很多方面的限制，所以更需要发挥社会整体的力量。研究者应该要进一步加强成瘾性障碍如酒精依赖等心理治疗的实践研究，并整合各种社会资源有效防范，任重道远。 参考文献 [1]张伯源主编.变态心理学.北京:北京大学出版社.2005.6 [2]弗洛伊德著，高觉敷译.精神分析引论.北京:商务印书馆.1984 [3]李密等编著.药物滥用与药物依赖性.北京:中国科技出版社.1992 [4]张继志主编.精神医学与心理卫生.北京:北京出版社.1994 [5]张雨新主编.行为治疗的理论和技术.北京:光明日报出版社.1989 [6]梁宝勇主编.变态心理学.天津:南开大学出版社.2005 [7]许彦松，方明昭.慢性酒精中毒所致抑郁症状的临床特征.中国心理卫生杂志.2000 [8]姜佐宁主编.药物成瘾的临床与治疗.北京:人民卫生出版社.1997 [9]曾文星，徐静主编.心理疗法:原则与方法.北京:北京医科大学出版社.2000 [10]郑晓边著.心理变态与健康.合肥:安徽人民出版社.2003 ?郑晓边著.心理变态与健康.合肥:安徽人民出版社.2003,P267-P272 loan management (post) review: 1, approval criteria have been implemented; 2, the contract is correct; 3, in line with the contract, payment; 4, no other major cases against loan security;、Reviewed by: date of record form 9: qilu bank borrowing by single years of maximum amount a maximum no-loan borrowers: borrowers: ... Borrower name number, line of credit expiry date year month day to year month day maximum number of years in the loan contract are the top line opened, the borrowed and requested your bank opened credit lines above, is hereby requested. Borrower signature: date agreed to open credit lines. Customer Manager signature: date agreed to open credit lines. Loan review signature: date line cancellation-I did not use the loan amount, your bank credit lines to be cancelled. -Credit loan principal repayment, your bank credit lines to be cancelled. Borrower signature: date-unused credit lines, agree to write off loans. -Credit loan principal repayment, agree to write off loans. Customer Manager signature: date case, agree to write off loans. Loan review signature: date of record form 16: qilu self credit for credit card cancellation application form name of borrower ID number and credit limit expiration date year month day to year month day year contract number self-service card-I do not use credit, your bank credit lines to be cancelled. -Credit loan principal repayment, your bank credit lines to be cancelled. Borrower signature: date-unused credit lines, agree to write off loans. -Credit loan principal repayment, agree to write off loans. Customer Manager signature: [11]郭本禹主编.异常心理学高级教程. 合肥:安徽人民出版社.2007 [12]张伯源主编.异常心理学.北京:北京大学出版社.2005 [13]刘志民，连智.三地区中学生使用药物、精神活性物质的流行病学调查比较.中国药物依 赖性杂志.2001，10(2):127-131 心理科学进展.2006，[14]郑希耕，李勇辉，隋南成.成瘾药物心理依赖及复发的脑机制研究. 14(4):522-531 [15]CHANEY, E.F.; O'LEARY, MR; AND MARLATT, G.A. Skill training with alcoholics. Journal of Consulting and Clinical Psycbology 46:1092-1104, 1978. [16]FINNEY, J.W., AND MONAHAN, S.C. The cost-effectiveness of treatment for alcoholism: A second approximation. Journal of Studies on Alcohol 57:229-243, 1996. [17]FINNEY, J.W.; NOYES, C.A.; A.L.; AND MOOS, R.H. Evaluating substance abuse treatment process models: 1. Changes on proximal outcome variables during 12-step and cognitive-behavioral treatment. Journal of Studies on Alcohol 59(4):371-- 380, 1998. [18]LONGABAUGH, R. "Next Generation Research Therapies for Alcohol Treatment in the 21st Century." Presentation at the American Society of Addiction Medicine conference in New York City during May 1999. [19]LITTLETON, J.M. Acamprosate in alcohol dependence: Implications of a unique mechanism of action. Journal of Addiction Medicine 1:115-125, 2007. [20]JI, D.; GILPIN, N.W.; RICHARDSON, H.N.; ET AL. Effects of naltrexone, duloxetine, and a corticotropin- releasing factor type 1 receptor antagonist on binge-like alcohol drinking in rats. Behavioural Pharmacology 19(1):1-12, 2008. [21]CHEN Ruiyu, XIE Jiajiang. Assessment and Analysis of MMPI in Alcohol Dependent Patient, Chinese Journal of Drug Abuse Prevention and Treatment ,2005, 11(3). [22]Denzin,The recovering alcoholic.New bury Park,CA:sage 1987.6Cautela, Cover sensitization. Psychological Report 1996 459-468 Review of alcohol dependence with psychotherapy Pang Ying (Jilin University School of Philosophy and Social Applied Psychology, Changchun 130012,China) loan management (post) review: 1, approval criteria have been implemented; 2, the contract is correct; 3, in line with the contract, payment; 4, no other major cases against loan security;、Reviewed by: date of record form 9: qilu bank borrowing by single years of maximum amount a maximum no-loan borrowers: borrowers: ... Borrower name number, line of credit expiry date year month day to year month day maximum number of years in the loan contract are the top line opened, the borrowed and requested your bank opened credit lines above, is hereby requested. Borrower signature: date agreed to open credit lines. Customer Manager signature: date agreed to open credit lines. Loan review signature: date line cancellation-I did not use the loan amount, your bank credit lines to be cancelled. -Credit loan principal repayment, your bank credit lines to be cancelled. Borrower signature: date-unused credit lines, agree to write off loans. -Credit loan principal repayment, agree to write off loans. Customer Manager signature: date case, agree to write off loans. Loan review signature: date of record form 16: qilu self credit for credit card cancellation application form name of borrower ID number and credit limit expiration date year month day to year month day year contract number self-service card-I do not use credit, your bank credit lines to be cancelled. -Credit loan principal repayment, your bank credit lines to be cancelled. Borrower signature: date-unused credit lines, agree to write off loans. -Credit loan principal repayment, agree to write off loans. Customer Manager signature: Abstract Alcohol dependence and related issues in today's society has become second only to vascular disease, cancer of the third-largest public health problem. Western psychology has become a community and the spirit of the research community more popular research topic. But in view of conditions, This country has not been given sufficient attention. This article will introduce the relevant definition of alcohol dependence. Manifestations and a variety of psychological treatment. Take effective measures to prevent alcohol dependence, Alcohol dependence study of the future should be based on relevant studies of psychological therapy. Meet the shortfall. Present a more effective treatment methods and to explore in depth the clinical empirical research. Keywords Alcoholism Alcohol dependence syndrome Psychotherapy loan management (post) review: 1, approval criteria have been implemented; 2, the contract is correct; 3, in line with the contract, payment; 4, no other major cases against loan security;、Reviewed by: date of record form 9: qilu bank borrowing by single years of maximum amount a maximum no-loan borrowers: borrowers: ... Borrower name number, line of credit expiry date year month day to year month day maximum number of years in the loan contract are the top line opened, the borrowed and requested your bank opened credit lines above, is hereby requested. Borrower signature: date agreed to open credit lines. Customer Manager signature: date agreed to open credit lines. Loan review signature: date line cancellation-I did not use the loan amount, your bank credit lines to be cancelled. -Credit loan principal repayment, your bank credit lines to be cancelled. Borrower signature: date-unused credit lines, agree to write off loans. -Credit loan principal repayment, agree to write off loans. Customer Manager signature: date case, agree to write off loans. Loan review signature: date of record form 16: qilu self credit for credit card cancellation application form name of borrower ID number and credit limit expiration date year month day to year month day year contract number self-service card-I do not use credit, your bank credit lines to be cancelled. -Credit loan principal repayment, your bank credit lines to be cancelled. Borrower signature: date-unused credit lines, agree to write off loans. -Credit loan principal repayment, agree to write off loans. Customer Manager signature: