Behavioral Couples Therapy for Women Alcoholic Patients

点击翻译按钮获取中文摘要

DESCRIPTION (provided by applicant): Among male alcoholic and drug abusing patients, behavioral couples therapy (BCT), the family involved treatment with the strongest research support, produces greater abstinence and better relationship functioning than typical individual-based treatment (IBT) and reduces social costs, partner violence, and emotional problems of the couple's children. Although interpersonal conflict and relationship factors play a particularly important role in the drinking problems of women, there have been no published, controlled studies of BCT with women alcoholic patients. The few studies of BCT that have included female alcoholic patients had too few female patients to examine the efficacy of BCT separately for male and female patients. Recent studies offer conflicting results. A conference presentation reported that BCT and IBT did not differ for women alcoholic patients because days abstinent increased similarly in the 6 months after both treatments. In contrast, the Pl's naturalistic study of BCT found that (a) women alcoholics improved significantly on days abstinent, alcohol-related problems, and relationship adjustment during treatment and in the year after treatment and (b) women alcoholics' outcomes after BCT did not differ from outcomes for male alcoholic patients. Further, the Co-PIs controlled study showed that BCT produced more days abstinent and better relationship outcomes than IBT for women patients with a primary drug abuse diagnosis. The majority of these women drug abuse patients had a comorbid alcohol problem diagnosis. This project will conduct a randomized clinical trial comparing BCT plus IBT with IBT alone for women alcoholic patients. Married or cohabiting female alcohol-dependent patients (N=160) will be randomly assigned to 26 treatment sessions over a 20-week period consisting of either: (a) BCT plus IBT; or (b) IBT for the patient alone. We will test the prediction that BCT+IBT will produce better outcomes than IBT alone as shown by data collected from patients and spouses during and immediately after treatment and at quarterly follow-ups for 12 months. Outcome domains will include substance use and problems, relationship adjustment and partner violence, and social costs. We will explore possible improvements in children's functioning after their parents receive BCT and potential mediators and moderators of outcome.