As a new year approaches, many people vow to cut back on bad habits. Excess drinking is often high on the list. Whether it's possible to just reduce alcohol use rather than quitting completely is hotly debated. The January 2009 issue of the Harvard Mental Health Letter addresses this question.

It can be difficult to encourage a person with a drinking problem to quit. Offering counseling on moderation - that is, no more than one drink per day for women or two per day for men - may help convince some problem drinkers to reduce their alcohol use before they suffer painful consequences.

Research into moderate or "controlled" drinking has shown that this strategy can be successful for people who have not yet developed a pervasive pattern of alcohol abuse, or who have experienced few negative consequences from drinking. The goal is to help them set goals and drinking limits before they cross the line into dependence. But the research shows that moderation is unlikely to be successful for individuals who already meet criteria for alcohol dependence.

For dependent drinkers, moderation can be used to encourage change. Dr. Michael Miller, editor in chief of the Harvard Mental Health Letter, notes that demanding abstinence too soon may drive away an individual who is at the brink of dealing with addiction more directly. A person who says he or she wants to start drinking in a more controlled way is indicating a desire to change. This can alert a clinician to a teachable moment. If these individuals try to limit their drinking for a while and find they are unable to do so, they may realize they have already developed dependence. That may be enough to motivate them to try to abstain.

Also in this issue:

• Treatment-resistant depression
• Mental health parity
• Social phobia and brain response
• Screening heart patients for depression
• Counseling helps smokers quit
• Treatment for anxious children

The Harvard Mental Health Letter is available from Harvard Health Publications, the publishing division of Harvard Medical School, for $72 per year. Subscribe at www.health.harvard.edu/mental or by calling 877-649-9457 (toll-free).