Psychological Interventions Alcohol Relapse — MRCPsych Paper B MCQ

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ModerateSubstance MisusePsychological Interventions Alcohol RelapseMRCPsych Paper B

An adult with moderate alcohol dependence has completed successful assisted withdrawal and is starting oral naltrexone to help prevent relapse. According to NICE CG115, which psychological intervention is an appropriate adjunct to this medication?

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Correct answer: E — Individual cognitive behavioural therapy focused on alcohol misuse

The correct answer is E. After successful withdrawal in moderate or severe alcohol dependence, NICE recommends considering acamprosate or oral naltrexone together with an individual psychological intervention focused specifically on alcohol misuse. Suitable interventions include cognitive behavioural therapy, behavioural therapy, and social network and environment-based therapy. Behavioural couples therapy is another option when an appropriate partner is willing to participate. Motivational interviewing is recommended as part of initial assessment and engagement, but not as the sole structured adjunct specified here. Mutual-aid groups such as Alcoholics Anonymous may provide additional support but do not replace the recommended psychological intervention. Non-directive counselling and EMDR are not recommended specifically for pharmacological alcohol-relapse prevention; EMDR may instead be indicated for a comorbid trauma-related disorder.

Reference: National Institute for Health and Care Excellence. Alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence (CG115), recommendations 1.3.6.1–1.3.6.3. 2011, subsequently updated. https://www.nice.org.uk/guidance/cg115/chapter/Recommendations