Multicultural Therapy for Alcoholism in Military Contexts

Introduction: Multidimensional Challenges in Treating Alcoholism

Treating alcoholism presents therapists with multi-dimensional issues. Multicultural understanding and the contextual setting of the client — encompassing profession, family history, work conditions, and exposure to extraordinary circumstances such as military service — dominate the settings within which psychotherapists are required to work. The lack of adequate and healthy outlets for feelings, and the absence of recreation, often lead to excessive and harmful drinking. Yet each case is an independent experience requiring the therapist to be flexible while remaining focused on creating value at all times. As such, a therapist's work with each client may be aptly described as a "discovery."

A psychologist deals with interpersonal exchanges using a worldview — that is, a group of attitudes — that helps shape their opinion of other people. Their worldview is partly governed by cultural experiences. In fact, multicultural and cross-cultural literature constantly highlights the following facts (Duncan, 2010):

1. Man is a multicultural being (Duncan, 2010);
2. One's lifetime experiences are governed and perceived from within one's respective cultural perspective (Duncan, 2010); and
3. Every interaction is cross-cultural (Duncan, 2010).

Psychologists are urged to understand the ways in which cultures differ from one another in the fundamental premises shaping the worldview. For instance, understanding that mainstream American individuals tend to prefer independence, focus on success and achievement, value logical decision-making, and seek to know and control their personal goals represents one important cultural aspect a therapist must recognize (Duncan, 2010).

An interesting and persuasive body of work, produced through thorough empirical analysis, describes a six-stage therapist development model — ranging from lay helper to senior professional — and discusses the significance of constant reflection. Authors maintain that constant reflection and a receptive attitude toward learning new things are essential for professional growth at every level of experience. In the field of psychology, personal growth accompanied by considering, defining, editing, refining, expanding, or completely altering how one works is beneficial. At this juncture, one must give due importance to integrity and how essential it is for therapists to have faith in the solutions and explanations they employ — or, in the words of Frank, how important it is to believe in the restorative power of applied therapeutic methods. Describing one's work in a way that preserves flexibility, reflects genuine belief in one's approach, and guards against unnecessarily restricting one's methods makes sound professional sense (Duncan, 2010).

Bibliography

American Psychological Association. (2003). Guidelines on multicultural education, training, research, practice, and organizational change for psychologists. American Psychologist, 58(5), 377–402.

Ames, G., & Cunradi, C. (2012). Alcohol use and preventing alcohol-related problems among young adults in the military. NIAAA.

Duncan, B. (2010). On becoming a better therapist. American Psychological Society. American Psychological Association.

Furuya, S. (2015). ASAP triage (brief screen case note) for confidential treatment program.

Ingram, B. L. (2006). Clinical case formulations: Matching the integrative treatment plan to the client. Wiley Publishing.

Larson, M. M. (2014). Missed opportunity for alcohol problem prevention among army active duty service members postdeployment. American Journal of Public Health.