A randomized clinical trial of behavioral couples therapy versus individually-based treatment for drug-abusing women.
A randomized clinical trial of behavioral couples therapy versus individually-based treatment for drug-abusing women.
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DOI：
10.1037/ccp0000185
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发表时间：
2017-04
影响因子：
5.9
通讯作者：
Muchowski PM
中科院分区：
文献类型：
--
作者：
O'Farrell TJ;Schumm JA;Murphy MM;Muchowski PM
行为伴侣疗法（BCT）比个体化疗法（IBT）更有效地治疗物质使用障碍（SUD）患者的物质和关系结局。本研究比较了BCT和IBT对吸毒妇女的治疗效果。61名女性，大多数为白色，30多岁，患有酒精以外的原发性SUD（74%阿片类药物诊断），男性伴侣被随机分配至13周的BCT +12步IBT（即BCT+IBT）或IBT的26个疗程。药物相关结局：禁欲天数百分比（PDA）、药物使用天数百分比（PDDU）、药物使用后果清单。关系结局：二元调整量表（DAS）和分离天数。在基线、治疗后和每季度1年随访时收集数据。在PDA、PDDU和药物相关问题上，BCT+IBT和IBT患者在1年随访期间均显示出显著（p <0.01）的大效应量改善（大多数时间段d > 0.8）。BCT+IBT与IBT相比，在较少的药物相关问题上显示出显著（p < .001）的大效应量（d =-0.85）优势，而BCT+IBT和IBT在PDA或PDDU上没有差异（p> .47）。在关系结局方面，与IBT相比，BCT+IBT在1年随访期间男性报告的DAS显著更高（p <0.001，d = 0.57），间隔天数更少（p = 0.01，d =-0.47）。BCT+IBT在提高关系满意度和预防关系破裂方面比IBT更有效。在物质使用和物质相关问题上，接受两种治疗的妇女都有实质性改善，接受BCT+IBT的妇女比IBT有更少的物质相关问题。
Behavioral couples therapy (BCT) is more efficacious than individually-based therapy (IBT) for substance and relationship outcomes among patients with substance use disorder (SUD). This study compared BCT with IBT for drug-abusing women. Sixty-one women, mostly White, late thirties, with primary SUD other than alcohol (74% opioid diagnosis), and male partners were randomized to 26 sessions over 13-weeks of BCT plus 12-step-oriented IBT (i.e. BCT+IBT) or IBT. Substance-related outcomes: percentage days abstinent (PDA), percentage days drug use (PDDU), Inventory of Drug Use Consequences. Relationship outcomes: Dyadic Adjustment Scale (DAS) and days separated. Data were collected at baseline, post-treatment, and quarterly for 1-yr follow-up. On PDA, PDDU, and substance-related problems, both BCT+IBT and IBT patients showed significant (p < .01) large effect size improvements throughout the 1-yr follow-up (d > .8 for most time periods). BCT+IBT showed a significant (p < .001) large effect size (d = −.85) advantage versus IBT on fewer substance-related problems, while BCT+IBT and IBT did not differ on PDA or PDDU (p’s > .47). On relationship outcomes, compared to IBT, BCT+IBT had significantly higher male-reported DAS (p < .001, d = .57) and fewer days separated (p = .01, d = −.47) throughout the 1-yr follow-up. BCT+IBT for drug-abusing women was more efficacious than IBT in improving relationship satisfaction and preventing relationship break-up. On substance use and substance-related problems, women receiving both treatments substantially improved, and women receiving BCT+IBT had fewer substance-related problems than IBT.