Parent training and couple therapy in alcohol treatment

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Children of parents who abuse alcohol are at increase risk for emotional, behavioral, and social problems and interventions are needed to address the clinical needs of these children. Unfortunately, our data gathered from surveys of parents who enter outpatient treatment with a drinking problem show that more than 60% refuse to allow their children to participate in individual or family treatment. Thus, treatments for adult patients that improve the family environment may hold the most promise for affecting the psychosocial adjustment of children who live in these homes. A promising approach is Behavioral Couples Therapy 9BCT), which focuses both on reducing substance use and improving family adjustment. Recently, Kelley and Fals-Steward (in press) found that children whose parents participated in BCT displayed higher psychosocial adjustment at post-treatment at post-treatment, 6-month, and 12-month follow-up than children whose patients participated in treatment as usual or a psycho-educational coupled-based attention control condition. These promising results indicate that BCT has effects on the family that extends beyond the couple to their children, even though the children themselves were not actively involved in treatment. The primary objectives of this exploratory/developmental grant application are to extend the results of the Fals-Steward and Kelley investigation by examining the effects of BCT on children as rated not only by parents, but also by other informants within the family system (i.e., children themselves) and those outside the family system (i.e., teachers), and to explore the potential beneficial effects of adding parent skills training to BCT on children living with alcohol dependent parents. Specifically, this project seeks to determine whether (a) Parent Skills BCT in outpatient treatment results in greater improvements in psychosocial adjustment of children living in these homes compartment to children whose alcoholic parents receive individual-based treatment only, and (b) explore factors that may mediate the relationship between Parent Skills BCT involvement and improvements in children's psychosocial adjustment, including anticipated reductions in parental alcohol use, domestic violence and improved dyadic adjustment (both husband-wife and parent-child).