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Psychosocial Alcohol Relapse — MRCPsych Paper B MCQ

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ModerateSubstance MisusePsychosocial Alcohol RelapseMRCPsych Paper B

A 46-year-old man with moderate alcohol dependence has successfully completed assisted alcohol withdrawal and wishes to remain abstinent. Acamprosate is being considered to reduce his risk of relapse. Which psychosocial intervention is most consistent with NICE guidance as a treatment to offer alongside relapse-prevention medication?

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Correct answer: C — Cognitive behavioural therapy focused on alcohol-related cognitions and behaviour

The correct answer is C. Following successful withdrawal in moderate or severe alcohol dependence, NICE recommends considering acamprosate or oral naltrexone together with an individual, alcohol-focused psychological intervention. Appropriate interventions include cognitive behavioural therapy, behavioural therapy, and social network and environment-based therapy. Motivational interviewing is an important component of initial assessment and engagement, but a readiness-to-change intervention alone is not the specified continuing psychological treatment in this situation. Psychoanalysis and EMDR are not recommended specifically for alcohol relapse prevention. Mutual-aid groups such as Alcoholics Anonymous may provide valuable additional community support, but attendance alone does not replace the structured psychological intervention recommended alongside medication.

Reference: National Institute for Health and Care Excellence. Alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence. CG115, recommendation 1.3.6.1. Published 2011; updated 2014. https://www.nice.org.uk/guidance/cg115/chapter/Recommendations