Mutual-help and contingency management — structured clinical viva

This is a psychosocial package and evidence-literacy viva, not a pharmacology quiz. She has AUD with early post-detox relapse risk and a spiritual-fit barrier to classic AA. Your job is to: (1) offer secular mutual-help and/or carefully framed 12-step options without coercion; (2) use intensive referral rather than a pamphlet; (3) explain that TSF is professional facilitation, not AA itself; (4) discuss whether alcohol-focused CM (breath/EtG-contingent reinforcers where available) or attendance CM can be used locally; (5) quote Cochrane 2020 and MATCH sensibly; (6) support Al-Anon for the husband as concerned-other mutual-help; (7) reframe “bribery” as contingent reinforcement of verified healthy behaviour with meta-analytic support.[1][2][3][4][5]

Integrated plan sketch. Post-detox medical follow-up; consider anti-craving medication if appropriate (separate topic); CBT/MI; schedule SMART Recovery first meeting this week; discuss sample AA open meeting if curiosity remains; thrice-weekly contact; if CM infrastructure exists, define alcohol-negative target with immediate reinforcers for 8–12 weeks; husband Al-Anon information; relapse prevention and crisis contacts.[1][3][5]