Alcohol Abuse Counselling
Calgary Addiction Service in Counselling
Individual alcohol abuse counselling is available at Sana Psychological for those unsure if they have an issue with alcohol, those who know they have an issue and are starting to explore treatment, as well as those who have been in long-term recovery. Support is also available for family members and loved ones who are currently being impacted by another person’s unhealthy relationship with alcohol. Treatment can be short-term (3-6 months) or long-term (6+ months) depending on your needs and preference. We offer in person support in Calgary & Airdrie as well as virtual counselling.
What is Alcohol Abuse?
In previous editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM), alcohol abuse was a step before Substance Dependence and was marked by problems created by alcohol in one’s life over the past twelve months.
In the most recent version of the DSM, alcohol abuse and substance dependence have merged and been replaced by the category of ‘Substance Use Disorders.’
The criteria for this diagnosis are:
Hazardous use:
You have used the substance in ways that are dangerous to yourself and/or others, i.e., overdosed, driven while under the influence, or blacked out. Social or interpersonal problems related to use: Substance use has caused relationship problems or conflicts with others.
Neglected major roles to use:
You have failed to meet your responsibilities at work, school, or home because of substance use.
Withdrawal:
When you stop using the substance, you experience withdrawal symptoms.
Tolerance:
You have built up a tolerance to the substance so that you have to use more to get the same effect.
Used larger amounts/longer:
You have started to use larger amounts or use the substance for longer amounts of time.
Repeated attempts to control use or quit:
You've tried to cut back or quit entirely, but haven't been successful.
Much time spent using:
You spend a lot of your time using the substance.
Physical or psychological problems related to use:
Your substance use has led to physical health problems, such as liver damage or lung cancer, or psychological issues, such as depression or anxiety.
Activities given up to use:
You have skipped activities or stopped doing activities you once enjoyed in order to use the substance.
Craving:
You have experienced cravings for the substance.
In order to be diagnosed with a substance use disorder, you must meet two or more of these criteria within a 12-month period. The number of criteria met determines the severity of the disorder. If you meet any of these criteria, it is an indication that your relationship with alcohol has become problematic and you may benefit from counselling, if not require more intensive treatment. Sana Psychological is here to help you determine where you are at and how to best move forward.
Ready to Get Started?
Common Signs of Alcoholism
It can be difficult to sort out if alcohol consumption is unhealthy or has crossed the line into alcohol dependence. This is not something that you have to figure out on your own. Remember, you are not a trained healthcare professional with experience in making such diagnoses and, even if you are, doing so with yourself or in your personal life is much different than doing it with others. Let Sana Psychological help you determine where things are at and provide recommendations accordingly.
This is an informal checklist to help you get a general idea of the extent of your or your loved one’s challenges with alcohol use. Read through the following list and answer whether the statement applies to you or not.
Some red flags of alcohol problems include:
- Increased consumption
- Not feeling drunk anymore when drinking the same amount or more
- Drinking to feel normal
- Drinking for escape
- Drinking to numb
- Drinking to ‘self-medicate’
- Drinking for pain management
- Drinking to help you sleep
- Increased tolerance
- Binge drinking
- Others commenting on your use
- Health problem (e.g., pancreatitis, liver issues)
- Work issues
- Relational issues
- Daily drinking
- Morning drinking
- Withdrawal symptoms-shakes, tremors, Delirium Tremens
- Sleep difficulties
- Isolation
- Removal from activities that you previously enjoyed
- Emotional flatness (called “anhedonia”)
- Alcohol use leading to other problematic behaviours-drug use, smoking, sexual acting out
- Drinking in isolation
- Mental illness
- Lying about, hiding, sneaking alcohol
- Increased anxiety and/or depression
- Increased hopelessness
- Suicidal thoughts, ideation, attempts
- Legal consequences, like a Driving While Impaired charge
- Previous stay in a rehab facility
- Previous participation in or recommendation to a 12-Step Program
If you are experiencing any of these symptoms, it would be a good time to start to explore alcohol counselling. These symptoms tend to appear after chronic alcohol use that has escalated in quantity, frequency and had a progressive impact on your life over time. These symptoms rarely present themselves when people are engaged in minimal or moderate drinking.
The Progressive Condition of Alcoholism
Many people think that you only have an alcohol issue if you are drinking in the morning, in isolation, and have lost your job, home, and family. This is a possible outcome with severe problems, but it is important to appreciate that alcohol use and dependence is a progressive condition. It starts off with a mild expression, which may look like binge drinking, consuming more than intended occasionally, and what many people identify as “normal” youth or college-aged drinking (although this behaviour can appear at any age or time). This phase can progress to a moderate expression if left untreated.
Moderate expression of issues with alcohol starts to look more obviously problematic to the person and their loved ones as you can start to see symptoms of lying, sneaking, drinking more frequently and with less effect, irritability, withdrawal symptoms, and many of the items listed in the self-test above. At the severe end of the spectrum, we see individuals who may not be able to work or engage relationally and who are severely physically, mentally, and emotionally unwell. Individuals at this stage benefit from and often need quite intensive treatment, including residential treatment and/or hospitalization.
The face of people who have problems with alcohol can be anybody of any gender, sexual orientation, race, or socioeconomic status. Dependencies are rooted in a genetic condition that is activated by the environment, exposure, stress, and/or trauma and, therefore, it cuts across all demographic lines. Most people are genetically at risk, but may not experience activation or expression of this underlying vulnerability, whereas others do.
When is it Time for Alcohol Use Counselling?
If you are here, chances are that you are recognizing you have a problem with alcohol or you are connected with someone who does.
Taking this step of considering support is a tremendous one so congratulations on making it here and starting to explore additional support. Anytime that you are concerned is a great time to start to explore further treatment. The role of the professional is to assess and help you determine where things are at and what next steps would be beneficial.
About Our Alcohol Abuse Treatment Approach
Our treatment process includes an initial 1-2 sessions which involve gathering as much background information as possible about you, including strengths, available coping network and tools, challenges, as well as information about your alcohol use. Information is gathered to know about all parts of you, not just your relationship with alcohol. From this, we will discuss what therapies and treatment options are available and fit best for your needs. This will be the foundation of creating a treatment plan.
Alcohol use counselling is about much more than just your consumption of substances, as alcohol use starts to increase for a variety of reasons and there will be many areas of life that you can start to address to support a reduction in alcohol use, such as relationships, feelings processing, physical health, sleep hygiene, and more. Discussion and exploration of other mental health issues, including depression and anxiety, will also be built into the treatment plan as these are common parts of alcohol abuse and dependence.
Sana Psychological’s clinicians have been trained in a variety of therapeutic modalities, including: Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), Acceptance and Commitment Therapy (ACT), Motivational Interviewing, 12-Step Facilitation, and more. These approaches are blended into sessions in a personalized way depending on your needs.
Follow-up appointments generally involve a check-in to see presenting issues and immediate things that have come up that you may want to process, follow-up on any suggestions provided in past appointments to get an idea of progress as well as roadblocks that are coming up, followed by a more in-depth exploration of challenges, patterns, and coping.
Sessions are active and engaged as our clinicians like to ask lots of questions and provide reflections, challenges, and psychoeducation along the way. At any point, if the therapeutic approach or goals need to be changed, please speak up and this will be processed. Sessions come from a non-judgmental, compassionate, empathetic place.
Sessions are offered in-person in Calgary, Airdrie, or by using Technology Assisted Counselling which can consist of phone or video sessions depending on need and preference. Information on fees is available here. Sessions are available to anyone who is in the province of Alberta, and may be available out of province depending on your clinician’s credentials.
Payment options generally include cash, credit card, debit, e-transfer, and direct billing with the specific carriers we can bill to varying by clinician.
Alcohol counselling can be short or long-term, depending on your needs. We prefer to meet with people over a longer period of time (6+ months) to ensure sustainability and maintenance of progress as problematic alcohol use tends to ebb and flow. If this does not work for your needs, that is okay too. We will do as much work as we can in the available sessions to get you to build a healthy recovery plan that you can tailor as needed.
Appointments and free 15 minute consultations can be scheduled online at anytime.
If you have questions about the services offered, do not hesitate to reach out. Email will be the quickest way to get in touch. We aim to respond to emails and phone calls within 1 business day.
Treatment for Those Suffering from Alcohol Dependence
For most, the journey of recovery involves an initial detoxification period. Sometimes medical support is required for this detoxification, particularly if you are at risk of or have a history of withdrawal symptoms, including seizures. External referrals and recommendations can be provided for this, as well you can ask your family doctor or medical professional for support. If you do not feel ready for detoxification, there are still lots that you can start exploring and changing in your life, which can help increase motivation and readiness to start stepping back from alcohol consumption.
During and after this period of detoxification, recovery action will be occurring. This can mean an exploration of underlying patterns and vulnerabilities, getting to understand triggers and what prompts the urge to use, identification of other areas where compulsive or addictive behaviour may be active, as well as starting to explore and spend time developing a relationship with self. It might also mean supporting other mental health symptoms, including depression and anxiety, that are present. Relationships will continue during this period of time but these may look different as you start to detach from environments and people who bring with them a higher risk of exposure to alcohol and triggers.
The first 3-6 months of recovery will be a period of tremendous growth and feeling; it is often uncomfortable and is a vulnerable time where the likelihood of relapse is high. Withdrawal and change are uncomfortable, but they come with great benefit. After six months, changes are more established and have become routine so things feel less effortful. The lifelong work involves continued awareness of triggers, vulnerabilities, boundaries, and ongoing development of a relationship with self.
We will work with you to determine what you need and what actions are possible. If any therapeutic strategies are desired that cannot be provided, such as group therapy, family therapy, in-depth trauma psychotherapy, or more intensive outpatient treatment, then recommendations can be provided to support you in your journey whether with other providers on the team or external to Sana Psychological.
Wherever you are at in this journey, it is an honour and a privilege to be a part of it.
Support for Loved Ones
Alcohol use treatment may also involve concerned family members or friends who have been impacted. They may come in individually for their own support and/or join some sessions or parts of sessions with the individual who has challenges with alcohol.
If you are a family member reading this and hoping your loved one will change but you are not sure if they are ready, I would encourage you to come in for yourself to look at your own health and recovery plan. Change in any member of a relational unit creates change for the whole unit, so perhaps change can start with you. Even if you are feeling that your personal changes are not having an impact on your loved one, it will provide you with the strength, resources, and ability to cope with an extremely difficult, draining, and challenging situation. If more in-depth family therapy is required then can be provided at Sana Psychological, recommendations can be provided to continue your psychotherapy journey.
Why Choose Sana Psychological?
We have been told that we offer education and insight into challenges that is different from what people have heard before, but in a good way! People appreciate how the information provided about the brain and the connection to behaviour provides a missing piece of the puzzle for them. This, combined with an engaged and empathetic approach, is what is offered at Sana Psychological. We are hands-on, detail-oriented, respectful, and intuitive. Your clinician brings a passion for problem substance and behaviour work in particular and seem to strike a good balance of calling people out where needed, while operating from a foundation of empathy and understanding.
Frequently Asked Questions
A: This is a great question. An individualized discussion is the best way to determine where you are at. However, even to ask this question is a red flag of problem drinking, even though you may not have crossed the line to dependence. Wondering, doubting, and worrying about alcohol consumption indicates it may be problematic. If you or a loved one are expressing concerns, it would be a good time to seek out a professional opinion on where you are at. If alcohol is creating or contributing to problems in your life; is something you use frequently (even in low quantities); is a routine part of your celebration and/or stress management then I would recommend you talk to someone about your relationship with alcohol.
A: There is a myriad of physical and mental health symptoms that can come from chronic alcohol consumption. Physically, common effects are liver cirrhosis, cancers, and unintentional injuries such as motor vehicle accidents, falls, burns, assaults, and drowning. Mentally and emotionally, people tend to experience a decrease in activities that had value for them in the past and relationships and work can be impacted as people become progressively more isolated and have difficulty functioning outside of their relationship with alcohol.
A: Yes. Alcohol abuse is problematic substance use that is usually creating challenges in people’s lives. However, with education, tools, and goals around alcohol use, change can usually be initiated and sustained. For those who have crossed the line to substance dependence, education, tools and goals are still the recommended treatment approach; however, people may notice more obstacles along the way to change. Individuals with dependence tend to need more intensive and long-term treatment than those with substance abuse issues. In an outpatient counselling setting, we can do an informal evaluation of where you are at and your needs and go from there.
A: This may be a recommendation for those who are evidencing clear signs of dependence. I do support an abstinence-based approach to treatment. However, I also recognize that this may not be possible or something that everyone is open to so we can talk further about your goals and how to get there, and how much a part of that alcohol will be.
A: No. In fact, usually, alcohol counselling pulls in many other parts of the person and life, including an exploration of relationships, self-worth/esteem, work, stressors, and coping. The thing we love about problem substance and behaviour counselling is that you get to look at everything!
A: We encourage people to look at all aspects of themselves and use tools that address physical, psychological, cognitive, spiritual, relational, cultural, and financial health. Recommendations and suggestions will be provided and you will decide what you are open to trying and we can develop a collaborative, realistic plan of how you will go about incorporating these changes into your life.
A: We would encourage you to seek out support for yourself. Learning about substance dependence and the brain, boundaries, healthy communication, and engaging in your own self-care and recovery can be tremendously impactful in helping you deal with a stressful situation. It can also provide healthy role modelling that can have a spillover effect on those around you. It’s a win-win!
A: There is nothing that you will ever “have” to do in your counselling journey. Any recommendations and strategies are completely optional and up to you to decide what is a fit and what is not. We may encourage people to consider peer support groups like AA as a component of their recovery plan, but there is no expectation that you go in this direction.
A: Of course! Relapses are often a part of the journey and are something that we will explore to see what information can be learned from them. While unfortunate, frustrating and upsetting, they are certainly not something that would exclude you from further engagement and participation in counselling. Please come back and talk about what happened so we can both learn from it. If people are struggling significantly and require more intensive treatment, such as a stay at a residential treatment facility, then this can be determined and recommendations provided.