RICHARD ROSENTHAL, MD: Well, it's a new idea that's developed the last several years, and it comes from people that have been looking at motivation and treatment. Very often when people are identified as having drinking problems, they may not really believe itbecause there's either denial on the person's part, or they don't really recognize the potential damage that their drinking behavior is doing to their families, their job, to their bodies. So, to just go right in and say, "You have to go have treatment now" may not be a very good match-up. It may drive the person away form treatment, in certain instances.
So, in order to get the person really to make the decision that they need treatment, it's useful to have that person usually, talking to a professional to discuss the issues in a much more discussion-oriented way. It's a conversation where the person will bring up with the problem drinker issues around drinking, get them to think about what the nature of their drinking behavior is about. Perhaps they can come to the conclusion that this is something that they might want to pursue in terms of getting treatment, as opposed to sort of being shoe-horned into something which they may be sort of carried kicking and screaming into, and then really not engage in in a helpful way.
DAVID MARKS, MD:Who's doing this pretreatment?
RICHARD ROSENTHAL, MD: Typically it's addiction professionals that would be doing that. But really, just to meet with the person to discuss it and have a conversation. There are other folks that have been trained to do these kinds of interventions, some of whom are primary care physicians, some of whom are substance abuse counselors. Usually, it's somebody with some kind of professional training. That does not mean that family members can't engage in a dialog, as long as it's not coercive and punitive, which is likely to raise somebody's hackles and get them to not think about it.
