DOMESTIC VIOLENCE OUTCOMES FOR BEHAVIORAL COUPLE THERAPY

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This R21 application targets the general objective of "identifying and assessing the effectiveness and outcomes of alcohol-related treatment." This project will use data from two prior NIAAA projects to study domestic violence outcomes after behavioral couples therapy (BCT). Although research shows a strong association between domestic violence and alcohol problems and 50-60% violence prevalence in the year before alcohol treatment, violence as an outcome after treatment had not been studied until the PI's recent VA-funded pilot study. This study examine domestic violence before and after BCT for 88 married/cohabiting male alcoholic veterans and used a non-alcoholic comparison sample. Results showed that male-to-female violence, which had a 64% prevalence rate in the year before BCT, was significantly reduced in the two years after BCT, and was nearly eliminated with alcohol abstinence. Among remitted alcoholics, domestic violence turned to the level of experienced by families without alcohol problems. The OVERALL GOALS of this R21 project are to replicate with a larger, more varied sample of males and to extend to female alcoholic patients our initial pilot study findings of dramatically reduced violence after BCT; and to learn more about factors related to violence after BCT by examining a treatment process model that emphasizes the role played by abstinence and by various aspects of treatment involvement during and after BCT. The primary objective is to study male-to-female violence in the relationships of male alcoholic patients using data already collected at baseline, and for a 2-year follow-up period from 309 married/cohabiting male alcoholic patients and their female partners who entered a BCT treatment program for alcoholism as part of two earlier projects funded by NIAAA to evaluate the effectiveness of BCT. This primary objective aims (1) to replicate and extend our initial pilot study findings of reduced violence after BCT, adding an emphasis on the role of treatment involvement and abstinence in these outcomes, and (2) to test explanatory models for domestic violence before and after BCT. The secondary objective is to study male-to-female violence in the relationships of female alcoholic patients using data from the two prior NIAAA projects on 105 married/cohabiting female alcoholic patients and their male partners. This objectives aims (1) to extend our initial pilot study findings to female alcoholic patients and (2) to explore explanatory models for domestic violence before and after BCT among female alcoholic patients.