Cost-benefit and cost-effectiveness analyses of behavioral marital therapy with and without relapse prevention sessions for alcoholics and their spouses

O’Farrell, Timothy J.; Choquette, Keith A.; Cutter, Henry S. G.; Brown, Elizabeth D.; Bayog, Rogelio D.; McCourt, William F.; Lowe, Judith; Chan, Alfredo; Deneault, Paul

doi:10.1016/s0005-7894(96)80032-3

Cited by 40 publications

(25 citation statements)

References 12 publications

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“…Dozens of studies in the psychology literature have demonstrated an offset effect, as the costs of psychotherapy are more than offset by decreases in medical service utilization after psychological treatment (for a review, see Chiles et al., 1999). While few studies in marital and family therapy (MFT) have addressed treatment effects this way, most of those that have support the use of couple‐ and family‐based treatment methods (Fals‐Stewart, O’Farrell, & Birchler, 1997; Finney, Riley, & Cataldo, 1991; Graves & Hastrup, 1981; Henggeler, Melton, & Smith, 1992; Law & Crane, 2000; O’Farrell et al., 1996; Kessler, Steinwachs, & Hankin, 1982, is an exception). In the most recent of these studies, clients receiving nonmanualized couple or family treatment experienced a decrease of more than 20% in medical service utilization in the 6 months following treatment, more than twice the percentage decrease found for clients receiving individual therapy (Law & Crane, 2000).…”

mentioning

confidence: 99%

Preliminary Estimates of Cost‐Effectiveness for Marital Therapy

Caldwell¹,

Woolley²,

Caldwell

2007

J Marital Family Therapy

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Cost-effectiveness of marital therapy was examined beginning with a simple question: If government or health insurers paid for the screening and, where indicated, empirically supported treatment of 100,000 randomly selected married persons (i.e., 50,000 couples) from the general population, would the financial benefits outweigh costs? Two empirically supported forms of marital therapy, behavioral marital therapy and emotionally focused therapy, were considered in aggregate as possible treatments of choice. Marital therapy appears to be cost-effective when paid for by government to reduce public costs of divorce or when paid for by insurers to offset the increased health-care expenses associated with divorce. Implications and specific needs for future research to substantiate these conclusions are discussed.

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mentioning

confidence: 99%

Preliminary Estimates of Cost‐Effectiveness for Marital Therapy

Caldwell¹,

Woolley²,

Caldwell

2007

J Marital Family Therapy

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“…Three studies (2 in alcoholism and 1 in drug abuse) have examined social cost outcomes after BCT (O'Farrell et al, 1996a(O'Farrell et al, , 1996bFals-Stewart, O'Farrell & Birchler, 1997). These social costs included costs for substance abuse-related health care, criminal justice system use for substance-related crimes, and income from illegal sources and public assistance.…”

Section: Social Cost Outcomes and Benefit-to-cost Ratiomentioning

confidence: 99%

“…Thus, for every dollar spent in delivering BCT, 5 dollars in social costs are saved. In addition, BCT was more cost-effective when compared with individual treatment for drug abuse (Fals-Stewart et al, 1997) and when compared with interactional couples therapy for alcoholism (O'Farrell et al, 1996b). …”

mentioning

confidence: 99%

Behavioral Couples Therapy for Alcoholism and Drug Abuse

O’Farrell

Schein

2011

Journal of Family Psychotherapy

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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...

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“…In addition, one study revealed positive outcomes for the children of couples who were involved in BCT and others showed decreases in social costs (O'Farrell et al, 1996a;O'Farrell et al, 1996b). Couple Group Therapy.…”

Section: Handbook Of Clinical Issues In Couple Therapymentioning

confidence: 99%

Couple Therapy and Addictions

Nelson

Sullivan

2007

Journal of Couple & Relationship Therapy

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Therapies for alcoholism, substance abuse, and other addictions traditionally focus on characteristics of individuals such as behaviors, thoughts, and emotions. These kinds of programs tend to target problems inside the abusing person rather than a relational system. Treatments that are more recent locate the problems within systems of people. Regardless of the locus or cause of the abuse or addiction, seen as arising from disease processes, systemic dynamics, or other mechanisms that lead to unfortunate habits and behaviors, utilizing the individual's partner or family in therapy has become an important part of successful treatment. This article reviews models of couple treatment for alcoholics and substance abusers in terms of initiation into treatment, primary treatment, and relapse prevention.

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Cost-benefit and cost-effectiveness analyses of behavioral marital therapy with and without relapse prevention sessions for alcoholics and their spouses

Cited by 40 publications

References 12 publications

Preliminary Estimates of Cost‐Effectiveness for Marital Therapy

Preliminary Estimates of Cost‐Effectiveness for Marital Therapy

Behavioral Couples Therapy for Alcoholism and Drug Abuse

Couple Therapy and Addictions

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