Nursing care of the alcoholic patient becomes multifaceted and complex with the presence of a psychiatric-mental health disorder. Although issues surrounding dual-diagnosis patients have been addressed in the literature, there is a paucity of research and theory regarding care of the patient who has both alcoholism and dissociative identity disorder. This article presents a synthesis of the nursing literature with the author's experience to elucidate factors that enhance healing. Nursing interventions that are unique and sensitive for the alcoholic patient with dissociative identity disorder are discussed.

Effective recovery from alcoholism demands commitment from both partners in a marriage. The focus of this qualitative study was to learn how couples progressed through recovery and how they achieved their goals conjointly. The Model of Recovering Alcoholics' Behavior Stages and Goal Setting was used as the theoretical base. Twenty-eight couples participated in the study. The author used analytic fieldwork to learn if spouses of alcoholics conformed to the same stages as indicated by the model and to learn the interactive effects of alcoholics' and spouses' stages. As a result, the author developed the Model of Alcoholic Spouses' Behavior Stages and Goal Setting. The research has implications for planning nursing care, determining when to intervene individually versus conjointly, and identifying indicators of relapse.