This article was printed in Therapy Today, in the Dilemmas section, October 2026. Written by Richard Turner MBACP, a specialist in addiction therapy working in private practice in London (rtaddictiontherapy.co.uk).
In my professional experience as a substance misuse practitioner in the probation service, I would use an alcohol screening tool such as AUDIT (Alcohol Use Disorders Identification Test) to help assess the person’s drinking. This involves asking a standard set of questions and calculating a score that indicates the likely level of risk and the most appropriate response. Depending on the outcome, this might involve alcohol-awareness work or referral to a specialist substance misuse service.
Binge drinking can be particularly easy to minimise because the person may not drink every day. However, consuming large amounts over a weekend can still cause serious harm and have significant consequences for work, health, driving and relationships.
Couples minimising the extent of substance use, either consciously or unconsciously, is not uncommon – shame may play a part, as may fear about the possible consequences of disclosure, particularly where children are involved.
People often seek help only once the consequences of their drinking become difficult to ignore. In this case, a drink-driving ban is a significant warning sign. Someone convicted of drink-driving may, in some circumstances, receive an Alcohol Treatment Requirement as part of their sentence. If not, I would explore patterns of binge drinking, triggers, the impact of alcohol and the use of drinks diaries. I would also be interested in the person’s understanding of what it means to be an ‘addict’ or ‘alcoholic’. There are still many unhelpful stereotypes, such as the belief that alcohol dependence only affects people who drink first thing in the morning or who visibly appear unable to function.
A free version of AUDIT is widely available on the internet – the therapist could consider working through the questions in a session to help the couple open up a more honest conversation, consider the discrepancy between how they describe their drinking and its actual consequences, and take greater responsibility for what is happening.
Developing greater honesty with themselves could provide an important foundation for change and recovery. If the therapist is concerned that the work lies beyond their competence, I would encourage them to trust that concern, seek supervision and consider referral. Taking the substance use seriously could protect not only the individual but also their partner and others around them.