Health psychology: concepts, research, and applications

Personal Change Plan: Alcohol Consumption

Overview My personal plan for change focuses on cutting down my alcohol consumption and working towards cessation. Although I am an extremely active and healthy individual, I have a growing concern regarding the frequency of my drinking and my growing tendency to binge on alcohol. I frequently feel physically ill and emotionally drained on the following days following my binges. In addition, while I have not yet experienced any work-related or legal issues connected to my drinking, I know that my romantic partner and several close friends are concerned about my use of alcohol. I've recently found myself feeling increasingly guilty about my drinking, and on several occasions I have been dishonest and secretive about my use of alcohol. These feelings and behaviors are of growing concern to me, and as such, I've decided to formulate a personal change plan regarding my drinking.

Personal History My family has a very long and extensive history of problem drinking and alcoholism. Both of my parents were heavy drinkers during my childhood and teens, and my brothers and two male cousins have all had alcohol-related legal issues during their adult years. I am well aware of the genetic component of alcoholism, and I realize that I am at risk for developing a drinking problem (Sasabe & Ishiura 2010) I have always abstained from drinking, and only began to drink when I was involved in a romantic relationship with a heavy drinker. I terminated this relationship, but I continued to drink more and more heavily. I recently began a new relationship, and my new partner does not drink or use any substances. I want to change my drinking habits because I don't feel physically healthy, and I know my drinking is affective my emotional stability, as I feel more depressed and anxious. I enjoy my current romantic relationship, and the majority of my close friends are light social drinkers. While I do not feel pressured or motivated to quit for them, I realize that my drinking could damage these relationships, and that is a huge consideration in my decision to cut back and eventually stop my use of alcohol.

Assessment of Drinking Patterns My first step in my personal change plan was to take an alcohol use assessment. Using a self-assessment tool offered on the Mayo Clinic web site, I was able to evaluate my current level of drinking, and, not surprisingly, my responses indicated a problem-drinking pattern. After researching more on problem drinking and alcoholism and prospective self-help solutions I learned that many problem drinkers find support through e-therapy or internet-based support (Postel et. al, 2010). After comparing these online programs with those of the Alcoholics Anonymous (Gross, 2010), I found that I preferred the independence and flexibility offered by online support programs, and created a user account on Alcohol Help Center 2.0.

Strategies and Tools Alcohol Help Center 2.0 has a variety of very useful tools that I have used to organize my change plan and educate myself about successful strategies for change. I plan to use a daily diary to track my drinking behaviors and consider how they might correspond to my feelings and general stress levels. The site also offers daily emails that include useful tips and reminders about how to cope with cravings, stress, and ideas for preventing a relapse. I like both the privacy and the flexibility of this site because they allow me to set my own drinking-related goal, so they are not abstinence-based. I have a particular aversion to twelve-step programs such as A.A. because I am not comfortable with group therapy, and I don't ascribe to the model of addiction as a disease, as outlined in AA's literature (Gross, 2010). Despite my misgivings with A.A., my overall goal is to quit drinking and remain abstinent, but I plan to cut down gradually over a period of two weeks, drinking no more than three drinks a day and no more than ten drinks total per week. In addition to using daily journaling and email updates on Alcohol Help 2.0, I plan to exercise daily during the hours of 5-9 p.m., when I typically have urges to drink. I am also in counseling with an individual therapist who I see weekly, and I intend to share this plan with her and use our sessions to discuss my progress and any difficulties I experience. While I realize that many programs emphasize the use of behavioral changes, such as avoiding places or people who trigger drinking, I have found that I am far more likely to isolate myself when I am under the influence of alcohol. I typically drink in my home, and frequently do so alone, and I want to make efforts to change these habits. I'm not comfortable with the idea of participating in a support group because I am prone to depression and anxiety, and I feel the experience of listening to other people's stories and struggles is likely to depress and overwhelm me rather than motivate me to change. I do, however, realize that I need to make more of an effort to socialize with sober friends and be involved with group activities. With this in mind I plan to schedule at least two activities per week with close friends. I also plan to join a book discussion group, which takes place on Friday nights and will give me an opportunity to meet new peers and take part in an activity I enjoy. I also realize that I need peer support to assist this change plan, and as such I will share this plan with a few trusted friends and my partner. My sense is that they will all be very supportive and understanding, and I believe they will encourage me without being overbearing or watchful. I'm lucky in the sense that my close friends and I all know that I have enormous willpower and capacity self-control, but I need to make some key behavioral changes before I can expect this plan to have lasting results. I will evaluate this plan and my drinking patterns at the two-week mark and adjust the plan as needed. Assuming I meet my goals for the first two weeks, I will continue with my program and abstain from drinking for the following two weeks. My overall goal is to make abstinence a long-term behavior, and I once I am abstinent I will develop a support and relapse prevention plan. Part of my long-term plan is to consult with my medical provider about the possibility of using a psychotropic medication to control my depressive symptoms and anxiety once I am no longer using alcohol. From my personal reading and physical experiences I think it is very likely that I am using alcohol to self-medicate an ongoing issue with low mood and anxiety, and I also plan to explore the use of yoga and meditation for mood and stress management, and I will be attending classes and workshops for both practices.