Behavioral Couples Therapy for Female Drug-Abusing Patients

女性吸毒患者的行为夫妻疗法

• 批准号: 8287684
• 负责人: TIMOTHY JAMES O'FARRELL
• 金额: $ 49.78万
• 依托单位: HARVARD MEDICAL SCHOOL
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-01 至 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8287684
• 关键词: Abstinence; Action Potentials; Aftercare; Alcohol or Other Drugs use; Alcohols; Anxiety; Behavioral; Child; Comorbidity; Controlled Study; Counseling; Couples; Couples Therapy; Data; Drug Addiction; Drug usage; Effectiveness; Family; Female; Health; Health Personnel; Heavy Drinking; Hospitalization; Individual; Mediating; Mental Depression; Meta-Analysis; Outcome; Outpatients; Parents; Patients; Pharmaceutical Preparations; Play; Post-Traumatic Stress Disorders; Randomized; Randomized Clinical Trials; Relative (related person); Reporting; Risk; Role; Sample Size; School-Age Population; Spouses; Substance abuse problem; Testing; Treatment outcome; Woman; Work; base; behavior prediction; divorce/separation; drug abuser; drug/alcohol abstinence; emotional adjustment; follow-up; group counseling; improved; interpersonal conflict; male; men; partner violence; primary outcome; problem drinker; psychosocial adjustment; randomized trial; satisfaction; secondary outcome; sexual violence; therapy outcome; trial comparing

Behavioral Couples Therapy for Female Drug-Abusing Patients Multiple studies indicate that participation in Behavioral Couples Therapy (BCT) is associated with robust positive outcomes for drug-abusing and alcoholic patients. BCT produced better outcomes than more typical individual-based treatment (IBT) for married or cohabiting drug-abusing and alcoholic patients in a meta-analysis of 12 controlled studies that showed a medium effect size favoring BCT over individual treatment. However, nearly all BCT studies have been done with male drug-abusing or alcoholic patients. Although interpersonal conflict and relationship factors play a particularly important role in the substance abuse problems of women, only 2 controlled studies (1 with drug-abusing and 1 with alcoholic women) have examined the efficacy of BCT with women patients. Both studies found positive results for BCT, but findings favoring BCT over IBT were less robust and less long-lasting for drug-abusing women. Drug-abusing women may present special challenges for BCT, relative to alcoholic women and drug- abusing or alcoholic men. They have greater relationship problems than these other types of substance-abusing couples. This may reduce the effectiveness of BCT by making it more difficult for the couple to work together collaboratively to promote abstinence in the female drug-abusing patient. A theoretical mechanism of change for BCT is that BCT improves relationship functioning during treatment more than IBT and this improved relationship functioning leads to better abstinence outcomes after treatment. However, if relationship improvements are only weakly better for BCT than IBT, this may undermine sustainability of abstinence in the year after treatment. Also, women drug-abuse patients often have extensive psychiatric problems (e.g, depression, PTSD) and male partners who drink heavily or use drugs - factors that may reduce (i.e. moderate) the impact of BCT relative to IBT. Theproposed studywillevaluateBCT for women drug-abusing patientsto determinewhetherthesuperiority of BCT over IBT outcomes observed for men generalizes to women drug-abusing patients. The study will replicate, extend, and overcome key limitations of the only prior study of BCT with female drug-abusing patients. This randomized trial compares BCT plus IBT with IBT alone for women drug-abusing patients. Married or cohabiting female drug-abusing patients(N=160)seeking outpatienttreatment and their non-substance-abusing male partners will be randomized to 24 treatment sessions over a 12-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 after treatment. Outcome domains examined will include substance use and problems, relationship adjustment, and partner violence. We also will explore possible improvements in children's functioning after their parents receive BCT, mechanisms of action and potential moderators for BCT outcomes.

女性药物滥用者的行为伴侣治疗 多项研究表明，参与行为夫妇治疗（BCT）与健康相关。 药物滥用和酗酒患者的积极结果。BCT产生的结果比更典型的 一项荟萃分析中已婚或同居药物滥用和酗酒患者的个体化治疗（IBT） 12项对照研究显示，BCT优于个体治疗的中等效应量。但近 所有的BCT研究都是在男性吸毒或酗酒患者中进行的。 虽然人际冲突和关系因素在实质上起着特别重要的作用 妇女的滥用问题，只有2项对照研究（1项涉及药物滥用，1项涉及酗酒妇女） 研究了BCT对女性患者的疗效。两项研究都发现了BCT的积极结果，但结果 对药物滥用妇女来说，BCT优于IBT的效果不太稳定，也不太持久。 与酗酒妇女和吸毒妇女相比，吸毒妇女可能对BCT提出特殊的挑战。 酗酒或酗酒的人。他们有更大的关系问题比这些其他类型的物质滥用 夫妻。这可能会降低BCT的有效性，使夫妻更难一起工作 合作促进女性吸毒者的戒断。一种理论上的变化机制， BCT是BCT改善治疗期间的关系功能超过IBT，这种改善的关系 功能导致治疗后更好的禁欲结果。然而，如果关系改善只是 BCT比IBT略好，这可能会破坏治疗后一年的禁欲持续性。还有， 女性药物滥用患者通常有广泛的精神问题（如抑郁症，创伤后应激障碍）和男性伴侣 重度饮酒或使用药物的人-可能降低（即缓和）BCT相对于IBT的影响的因素。 拟议的研究将评估女性吸毒患者的BCT，以确定是否具有优越性 在男性中观察到的BCT优于IBT的结局可推广至女性药物滥用患者。研究会重复进行 扩展并克服了之前唯一一项针对女性吸毒患者的BCT研究的关键局限性。这 一项随机试验比较了BCT联合IBT与单独IBT治疗女性药物滥用患者的效果。已婚或同居 寻求门诊治疗的女性药物滥用患者（N=160）及其非药物滥用男性伴侣 将在12周内随机接受24次治疗，包括：（a）BCT + IBT;或（B） IBT仅用于患者。我们将检验BCT + IBT将产生比单独IBT更好的结局的预测 如在治疗期间和治疗后立即以及每季度从患者及其配偶收集的数据所示， 治疗后随访12个月。审查的成果领域将包括药物使用和问题， 关系调整和伴侣暴力我们还将探索儿童功能的可能改善 在他们的父母接受BCT后，BCT结果的作用机制和潜在调节因素。