Alcohol‐Focused Behavioral Couple Therapy

Abstract

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.

Couple therapy, family therapy and systemic interventions for adult‐focused problems: the current evidence base

“…Wide‐ranging narrative reviews by McCrady et al . () and O'Farrell and Clements () concluded that systemic interventions were effective in helping sober families promote the engagement of family members with alcohol problems in treatment, and in helping people recover from alcohol problems. This conclusion is shared by other major reviews (Blonigen et al ., ; Fletcher, ; Meis et al ., ; Powers et al ., ; Ruff et al ., ; Templeton et al ., ; Wesley and Chanel, ).…”

“…For helping people with alcohol problems recover, McCrady et al . () and O'Farrell and Clements () concluded that behavioural couple therapy, in many circumstances, was more effective than other approaches. Compared with individual approaches, behavioural couple therapy produced greater abstinence, fewer alcohol‐related problems, greater relationship satisfaction, and better adjustment in children of people with alcohol problems.…”

Predictors of Utilization of an Addiction-Specific Behavioural Couple Therapy in Alcohol Dependence

“…This treatment approach includes alcohol-focused interventions to reduce the drinking behaviour and reach abstinence and relationship-focused interventions aiming to increase positive feelings, couple activities and communication skills [2]. Several randomized controlled trials demonstrated the efficacy of BCT [3]. Results of a meta-analysis showed significantly better follow-up outcomes for BCT relative to individual-based treatment concerning reduction in frequency of use, reduction in negative consequences of use and increase in relationship satisfaction [4].…”

Editorial: Integration in Couple and Family Therapy

“…Pioneers in our field such as Minuchin () and Whitaker and Keith () fought for having the system actively engaged in therapy for a multitude of reasons; ones often lost today in clinical practice. Research shows us the special value of, for example, including the partner in treatment of difficulties such as depression (Whisman & Beach, ), chemical dependency (McCrady et al., ), or PTSD (Monson & Fredman, ), but how many therapists will push for that inclusion or even have the option to do that in a system that funnels those clients to individually trained clinicians? Clearly at times, the healthcare system, with its focus on individual diagnosis, creates a pathway to ignoring the systemic.…”