ABSTRACT
The CBT approach to problem drinking is based on the assumption that excessive and harmful alcohol use develops through the interactive processes of classical and operant conditioning, modelling and cognitive mediation (Gorman, 2001). It follows, from this assumption, that contextual and environmental factors are crucial in the initiation, maintenance and change of problem drinking, and that therapeutic interventions should primarily emphasize engagement in new behaviours in contexts that are problematic for the client. A further assumption is that each client presents a unique case that requires a thorough understanding, or a case formulation, in order for CBT to be successful (Spada, 2006a). Approaching each client uniquely entails delineating the particular composition of cognitive-behavioural forces that lead to, and maintain, problem drinking. In addition to adherence to these basic assumptions, CBT for problem drinking places a heavy emphasis on the empirical validity of its models and ef®cacy of its therapeutic interventions. With these key assumptions as background, let us now turn to considering the processes viewed as central to the initiation, maintenance and change of problem drinking, and to the key therapeutic interventions based on these processes.
