Behavior change patterns and strategies distinguishing moderation drinking and abstinence during the natural resolution of alcohol problems without treatment

Behavior change patterns and strategies involved in natural resolutions that resulted in stable moderation drinking or abstinence were investigated, using untreated problem drinkers with different drinking statuses. Participants' drinking practices and problems, resolution patterns, behavior-change strategies, and barriers to help seeking were assessed during structured interviews. Collaterals verified participants' reports. Most abstinent resolutions were initiated abruptly. Moderation resolutions were achieved more gradually and entailed changes in drinking practices like those emphasized in behavioral self-control treatments. Participants' desire to solve their own problem and concerns about available interventions deterred help seeking, even though help was widely available. These data suggest that variability exists in how drinking problems are resolved and that interventions should support the several successful resolution patterns.