Psychosocial Interventions for Alcohol Use Disorder: A Review of Efficacy, Mechanisms, and Clinical Implications.

Alcohol use disorder (AUD) is a prevalent global health challenge associated with substantial morbidity, mortality, and socioeconomic burden, yet significant gaps remain in access to effective treatment. Psychosocial interventions are fundamental components of evidence-based care for AUD and play a critical role in promoting abstinence, reducing harmful alcohol consumption, preventing relapse, and improving psychosocial functioning. Despite the availability of several established therapeutic approaches, comprehensive syntheses comparing their effectiveness, mechanisms of action, and emerging applications remain limited. This narrative review synthesizes recent evidence on major psychotherapeutic interventions for AUD, including Cognitive-Behavioral Therapy (CBT), Motivational Interviewing (MI), Contingency Management (CM), Mindfulness-Based Relapse Prevention (MBRP), Twelve-Step Facilitation (TSF), and Behavioral Couples Therapy (BCT). Current evidence suggests that combined treatment modalities, particularly MI integrated with CBT, demonstrate superior outcomes in reducing alcohol consumption and enhancing treatment engagement. CBT is effective across the full spectrum of AUD severity; CM facilitates rapid initiation of abstinence through reinforcement strategies; TSF promotes sustained recovery by strengthening social support and participation in mutual-help programs; MBRP is particularly beneficial for individuals with heightened stress reactivity and relapse vulnerability; and BCT improves drinking outcomes and relationship functioning. Emerging developments include digital and mobile health interventions, integration of psychosocial therapies with pharmacological treatment, precision medicine approaches tailored to individual patient characteristics, and expanded implementation in low- and middle-income countries. This review aims to evaluate the effectiveness of psychosocial interventions on abstinence rates and other alcohol-related outcomes in individuals with AUD while highlighting current evidence, clinical applications, and future directions for optimizing treatment.