Women with alcohol use disorder (AUD) experience more barriers to AUD treatment and are less likely to access treatment than men with AUD. A literature review identified several barriers to women seeking help: low perception of a need for treatment; guilt and shame; co-occurring disorders; employment, economic, and health insurance disparities; childcare responsibilities; and fear of child protective services. Women entering treatment present with more severe AUD and more complex psychological, social, and service needs than men. Treatment program elements that may reduce barriers to AUD treatment include provision of childcare, prenatal care, treatment for co-occurring psychological problems, and supplemental social services. Research has suggested that outcomes for women are best when treatment is provided in women-only programs that include female-specific content. To date, research on treatments tailored to the individual needs of women is limited, but research on mechanisms of change has suggested the importance of targeting anxiety and depression, affiliative statements in treatment, abstinence self-efficacy, coping skills, autonomy, and social support for abstinence. Future research should focus on early interventions, linkages between primary care or mental health clinics and AUD treatment settings, and integrated treatments for co-occurring AUD and other disorders. Further research should also explore novel treatment delivery approaches such as digital platforms and peer support groups.

Alcohol Behavioral Couple Therapy (ABCT) has emerged over the last 30 years as a highly efficacious treatment for those with alcohol use disorders. This review highlights the historical and conceptual underpinnings of ABCT, as well as the specific treatment elements and structure. Proposed active ingredients, moderators, and mediators of treatment outcome are discussed. Efficacy is evaluated for reductions in identified patient drinking, improved relationship functioning, and reductions in intimate partner violence. Adaptations of ABCT for substances other than alcohol are described. Other adaptations, including brief interventions, interventions addressing PTSD and TBI along with alcohol use, and interventions deliverable via technology platforms are described. Additional cost-benefit and cost-effectiveness findings supporting the economic value of ABCT are noted. Future directions for research in this area include possible adaptations for female identified patients, non-traditional couples, LGBT partners and dyads involving non-intimate partner relationships. The development of more flexible models and enhanced dissemination strategies may improve clinical uptake and utility as well as increasing the feasibility of this treatment for integrated healthcare settings.

introduction: Previous exercise intervention studies for smoking cessation have been challenged by a number of methodological limitations that confound the potential efficacy of aerobic exercise for smoking cessation.

Inpatient smokers with major depressive disorder (MDD) have high rates of relapse to smoking after hospital discharge. The risk of health consequences that may contribute to increased morbidity and mortality among this population underscores the need to develop a program for psychiatric inpatient cigarette smokers with MDD. Using a motivational interviewing (MI) intervention, we sought to facilitate engagement of smokers with elevated depression symptoms in an outpatient treatment with demonstrated efficacy for nicotine dependence. In Phase 1 of this program, we recruited 15 smokers with MDD who were receiving inpatient psychiatric services. This preliminary report focuses on the development of the intervention, and explores perceived barriers to quitting, methods of quitting, and interest in smoking cessation treatment following discharge from an inpatient stay. Understanding inpatient cigarette smokers’ interests in making changes in smoking, and in willingness to attempt cessation and engage in cessation treatment can inform efforts to curb smoking in this high-risk population.