TABLE 3.

Behavioral modalities for treatment of alcohol use

Behavioral therapy	Provider delivering intervention	Efficacy in ALD	Description
Screening, Brief Intervention, Referral to Treatment (SBIRT)	Any clinician	20–23% achieve abstinence w/ SBIRT	Providing screening for alcohol use, brief (usually motivationally interviewing themed) discussion on alcohol reduction, and referral to alcohol treatment where indicated.
Cognitive behavior therapy (CBT)	Trained MHSAa provider	CBT/MET for 2 y: 74% increase in abstinence vs. 48% in controls	Focuses on modifying dysfunctional thoughts, emotions, and behaviors. In AUD treatment, used to identify cues and triggers for relapse, improve coping strategies, substance-refusal training, increase focus on substance-free activities.
Motivational enhancement therapy (MET)/motivational interviewing (MI)	Any clinician	CBT/MET for 2 y: 74% increase in abstinence v 48% in controls	MI and it is more structure version (MET) are widely used, evidence-based approaches for eliciting and strengthening personal motivation to change. Especially helpful for those who are ambivalent about or resistant to positive behavior change.
12-step facilitation	Trained MHSAa provider	Unknown, no data	Therapy modality in which focuses on total alcohol abstinence and regular participation in 12-step/alcohol-associated anonymous meetings
Contingency management	Trained MHSAa provider	Unknown, no data	Intervention based on operant conditioning where patients receive an incentive (often financial) in exchange for evidence of reduction in use or abstinence

^aMHSA: mental health/substance abuse provider

Abbreviations: ALD, alcohol-associated liver disease; AUD, alcohol use disorder.

Adapted from Leggio and Mellinger.⁷⁹