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      Behavioral Couples Therapy for Alcoholism and Drug Abuse: Where We’ve Been, Where We Are, and Where We’re Going

      , , , ,
      Journal of Cognitive Psychotherapy
      Springer Publishing Company

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          Abstract

          Among the various types of couple and family therapies used to treat substance abuse, Behavioral Couples Therapy (BCT) has the strongest empirical support for its effectiveness. During the last 3 decades, multiple studies have consistently found participation in BCT by married or cohabiting substance-abusing patients results in significant reductions in substance use, decreased problems related to substance use (e.g., job loss, hospitalization), and improved relationship satisfaction. Recently, investigations exploring other outcomes have found that, compared to traditional individual-based treatments, participation in BCT results in significantly (a) higher reductions in partner violence, (b) greater improvements in psychosocial functioning of children who live with parents who receive the intervention, and (c) better cost-benefit and cost-effectiveness. In addition to providing an overview of the theoretical underpinnings of BCT, methods used with this intervention, and the literature supporting its use, this article also examines the future directions of BCT research for substance abuse.

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          Most cited references34

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          The disease concept of alcoholism.

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            Outcome, attrition, and family-couples treatment for drug abuse: a meta-analysis and review of the controlled, comparative studies.

            This review synthesizes drug abuse outcome studies that included a family-couples therapy treatment condition. The meta-analytic evidence, across 1,571 cases involving an estimated 3,500 patients and family members, favors family therapy over (a) individual counseling or therapy, (b) peer group therapy, and (c) family psychoeducation. Family therapy is as effective for adults as for adolescents and appears to be a cost-effective adjunct to methadone maintenance. Because family therapy frequently had higher treatment retention rates than did nonfamily therapy modalities, it was modestly penalized in studies that excluded treatment dropouts from their analyses, as family therapy apparently had retained a higher proportion of poorer prognosis cases. Re-analysis, with dropouts regarded as failures, generally offset this artifact. Two statistical effect size measures to contend with attrition (dropout d and total attrition d) are offered for future researchers and policy makers.
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              Alcoholism treatment by disulfiram and community reinforcement therapy.

              Traditional disulfiram treatment has often been ineffective because of a failure to maintain usage. The present study with 43 alcoholics compared: (1) a traditional disulfiram treatment, (2) a socially motivated Disulfiram Assurance program and (3) a Disulfiram Assurance program combined with reinforcement therapy. About five sessions were given for each program. At the 6-month follow-up, the traditional treatment clients were drinking on most days and no longer taking the medication. The Disulfiram Assurance treatment resulted in almost total sobriety for married or (cohabitating) clients but had little benefit for the single ones. The combined program produced near-total sobriety for the single and married clients. These results indicate a promising integration of chemical, psychological and social treatment of alcoholism.
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                Author and article information

                Journal
                Journal of Cognitive Psychotherapy
                J Cogn Psychother
                Springer Publishing Company
                0889-8391
                1938-887X
                July 01 2005
                July 2005
                July 2005
                July 01 2005
                : 19
                : 3
                : 229-246
                Article
                10.1891/jcop.2005.19.3.229
                fe135726-957e-4d26-9c9c-0a48fc333fae
                © 2005
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                Genetics

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