Behavioral marital therapy for male alcoholics: Marital and drinking adjustment during the two years after treatment

O’Farrell, Timothy J.; Cutter, Henry S. G.; Choquette, Keith A.; Floyd, Frank J.; Bayog, Rogelio D.

doi:10.1016/s0005-7894(05)80220-5

Cited by 92 publications

(72 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Moreover, couples with more severe marital problems, as well as more severe alcohol problems, are the most likely to relapse (O'Farrell et al 1992). Two studies have assessed the value of additional relapse prevention (RP) sessions following standard ABCT for alcoholism.…”

Section: Rp: Relapse Preventionmentioning

confidence: 99%

Marital and Family Processes in the Context of Alcohol Use and Alcohol Disorders

Leonard

Eiden²

2007

Annu. Rev. Clin. Psychol.

252

211

View full text Add to dashboard Cite

Alcohol use is often part of the fabric of marriage and family life, and although it is associated with certain positive effects, excessive drinking and alcohol disorders can exert a negative effect on the marital development and on the development of children in the context of the family. This review considers evidence that alcohol influences and is influenced by marital/family processes, including transitions into marriage and parenthood, marital satisfaction, marital violence, parenting, and child development. The review discusses the importance of antisocial behavior and the need to examine women's drinking, and the joint impact of men's and women's drinking on marital/family processes. The review highlights the lack of studies in certain key areas, including the link between discordant drinking and violence and marital satisfaction, the role of alcohol in child neglect, and the potential role of marital conflict as a mediator or moderator of the relationship between alcohol and child functioning.

show abstract

Section: Rp: Relapse Preventionmentioning

confidence: 99%

Marital and Family Processes in the Context of Alcohol Use and Alcohol Disorders

Leonard

Eiden²

2007

Annu. Rev. Clin. Psychol.

252

211

View full text Add to dashboard Cite

show abstract

“…For example, some agents, such as naltrexone for opioid dependence or disulfiram for alcohol dependence, are associated with limited patient acceptance and adherence (Fuller et al, 1986;Modesto-Lowe and Van Kirk, 2002;O'Brien, 1997;Rounsaville, 1995) in part because they are too powerful in preventing relapse to substance use if taken properly. Unless combined with some type of targeted behavioral intervention, ranging from family assisted compliance contracting (O'Farrell et al, 1992a), to direct monitoring of medication compliance (Rigsby et al, 2000), to providing incentives for adherence (Preston et al, 1999), the pharmacologic efficacy of these agents may not translate into treatment efficacy in the context of clinical trials. In general, the limited treatment adherence in many pharmacotherapy trials for substance abusers (de Lima et al, 2002;Rohsenow et al, 2000) requires the incorporation of medication adherence strategies into any behavioral platform chosen.…”

Section: Enhancing Medication Adherencementioning

confidence: 99%

“…Although level of efficacy varies with the specific type of family/couples intervention, empirical support for several types of family/couples treatment is strong (Stanton and Shadish, 1997) and there is evidence that involving the patient's spouse in treatment can foster medication adherence, particularly where compliance contracts are used Chick et al, 1992;Fals-Stewart et al, 1997;O'Farrell et al, 1992a;O'Farrell and Litten, 1992b).…”

Section: Family and Couples Approachesmentioning

confidence: 99%

Choosing a behavioral therapy platform for pharmacotherapy of substance users

Carroll

Kosten

Rounsaville

2004

Drug and Alcohol Dependence

View full text Add to dashboard Cite

Behavioral therapy platforms have become virtual requirements in pharmacotherapy trials due to their utility in reducing noise variability, preventing differential medication adherence and protocol attrition, enhancing statistical power and addressing ethical issues in placebo-controlled trials. Selecting an appropriate behavioral platform for a particular trial requires study-specific tailoring, taking into account both the stage of development of the medication being evaluated, as well as the specific strengths and weaknesses of a broad array of available empirically supported behavioral therapies and the range of their possible targets (e.g., enhancing medication adherence, preventing attrition, addressing co-morbid problems, fostering abstinence, and targeting specific weaknesses of the pharmacologic agent). Choosing a suitable behavioral platform also requires consideration of the characteristics of the population to be treated, stage of scientific knowledge regarding the medication's effects, appropriate balance of internal and external validity, and consideration of potential ceiling effects. Available manualized behavioral treatments are reviewed, noting their strengths and limitations as behavioral therapy platforms for pharmacotherapy trials and as potential concomitant therapies in clinical practice.

show abstract

“…The studies show a fairly consistent pattern of more abstinence and fewer substancerelated problems, happier relationships, and lower risk of couple separation and divorce for substance abusing patients who receive BCT than for patients who receive only more typical individual-based treatment. These results come from studies with mostly male alcoholic (Azrin, Sisson, Meyers & Godley, 1982;Bowers & Al-Rehda, 1990;Chick et al, 1992;Hedberg & Campbell, 1974;Fals-Stewart, Klosterman, Yates, O'Farrell & Birchler, 2005;McCrady, Stout, Noel, Abrams & Nelson, 1991;O'Farrell, Cutter, Choquette, Floyd & Bayog, 1992) and drug abusing (Fals-Stewart, Birchler & O'Farrell, 1996;Fals-Stewart & O'Farrell, 2003;FalsStewart, O'Farrell & Birchler, 2001a, 2001b) patients and also with female alcoholic (Fals-Stewart, Birchler & Kelley, 2006) and drug abusing patients (Winters, Fals-Stewart, O'Farrell, Birchler & Kelley, 2002).…”

Section: Primary Clinical Outcomes: Abstinence and Relationship Functmentioning

confidence: 99%

“…Fals-Stewart, O'Farrell and Martin (2002) found that BCT produced better compliance with HIV medications among HIV-positive drug abusers in an outpatient drug abuse treatment program than did treatment as usual. BCT also has improved compliance with pharmacotherapy in studies of disulfiram for alcoholic patients [e.g., Azrin et al, 1982;Chick et al, 1992;O'Farrell et al, 1992) and in a pilot study of naltrexone with alcoholics .…”

Section: Integrating Bct With Recovery Related Medicationmentioning

confidence: 99%

Behavioral Couples Therapy for Alcoholism and Drug Abuse

O’Farrell

Schein

2011

Journal of Family Psychotherapy

Self Cite

View full text Add to dashboard Cite

Behavioral Couples Therapy (BCT) is designed for married or cohabiting individuals seeking help for alcoholism or drug abuse. BCT sees the substance abusing patient together with the spouse or live-in partner. Its purposes are to build support for abstinence and to improve relationship functioning. BCT promotes abstinence with a "recovery contract" that involves both members of the couple in a daily ritual to reward abstinence. BCT improves the relationship with techniques for increasing positive activities and improving communication. BCT also fits well with 12-step or other self-help groups, individual or group substance abuse counseling, and recovery medications. Research shows that BCT produces greater abstinence and better relationship functioning than typical individual-based treatment and reduces social costs, domestic violence, and emotional problems of the couple's children. Thus research evidence supports wider use of BCT. We hope this article and new print and web-based resources on how to implement BCT will lead to increased use of BCT to the benefit of substance abusing patients and their families. KeywordsBehavioral Couples Therapy; alcoholism; drug abuse OverviewThe purpose of Behavioral Couples Therapy (BCT) is to build support for abstinence and to improve relationship functioning among married or cohabiting individuals seeking help for alcoholism or drug abuse. BCT sees the substance abusing patient with the spouse or live-in partner to arrange a daily "Recovery Contract" in which the patient states his or her intent not to drink or use drugs and the spouse expresses support for the patient's efforts to stay abstinent. For patients taking a recovery-related medication (e.g., disulfiram, naltrexone), daily medication ingestion witnessed and verbally reinforced by the spouse also is part of the contract. Self-help meetings and drug urine screens are part of the contract for most patients. BCT also increases positive activities and teaches communication skills.Research shows that BCT produces greater abstinence and better relationship functioning than typical individual-based treatment and reduces social costs, domestic violence, and emotional problems of the couple's children. Despite the strong evidence base supporting BCT, it is rarely used in substance abuse treatment programs. Low use of BCT may stem from the recency of studies on BCT, many of which were published in the past 15 years. NIH Public Access Clinical Procedures for Behavrioal Couples TherapyBCT works directly to increase relationship factors conducive to abstinence. A behavioral approach assumes that family members can reward abstinence --and that alcoholic and drug abusing patients from happier, more cohesive relationships with better communication have a lower risk of relapse. The substance abusing patient and the spouse, are seen together in BCT, typically for 12-20 weekly outpatient couple sessions over a 3-6 month period. BCT can be an adjunct to individual counseling or it can be the only substance abuse counseling...

show abstract

Behavioral marital therapy for male alcoholics: Marital and drinking adjustment during the two years after treatment

Cited by 92 publications

References 20 publications

Marital and Family Processes in the Context of Alcohol Use and Alcohol Disorders

Marital and Family Processes in the Context of Alcohol Use and Alcohol Disorders

Choosing a behavioral therapy platform for pharmacotherapy of substance users

Behavioral Couples Therapy for Alcoholism and Drug Abuse

Contact Info

Product

Resources

About