Unilateral relationship enhancement in the treatment of spouses of uncooperative alcohol abusers

Thomas, Edwin J.; Adams, Kathryn Betts; Yoshioka, Marianne R.; Ager, Richard

doi:10.1080/01926189008250982

Cited by 47 publications

(51 citation statements)

References 18 publications

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“…They reported a 53% reduction in alcohol consumption in those users whose family members received the intervention and a slight increase in consumption in the control group; and that for eight of the problem alcohol users whose family member received treatment, the drinking was reduced or the drinker entered treatment compared to none in the control group. In a later study of UFT, Thomas & Ager [104] reported that 57% of drinkers entered treatment compared to 31% in the no-treatment control condition. Interventions were delivered over a period of 6 months and aimed to improve family member coping and family interactions and encourage treatment entry for the drinker.…”

Section: Joint Involvement Of Family Members and Substance-misusing Rmentioning

confidence: 96%

Family interventions in the treatment of alcohol and drug problems

Copello

Velleman

Templeton

2005

Drug and Alcohol Review

239

157

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Alcohol and drug problems affect not only those using these substances but also family members of the substance user. In this review evidence of the negative impacts substance misuse may have upon families are examined, following which family-focused interventions are reviewed. Several family-focused interventions have been developed. They can be broadly grouped into three types: (1) working with family members to promote the entry and engagement of substance misusers into treatment; (2) joint involvement of family members and substance misusing relatives in the treatment of the latter; and (3) interventions responding to the needs of the family members in their own right. The evidence base for each of the three types is reviewed. Despite methodological weaknesses in this area, a number of conclusions can be advanced that support wider use of family focused interventions in routine practice. Future research needs to focus on (1) pragmatic trials that are more representative of routine clinical settings; (2) cost-effectiveness analyses, in terms of treatment costs and the impact of interventions on costs to society; (3) explore treatment process; and (4) make use of qualitative methods. In addition, there is a need to define more clearly the conceptual underpinnings of the family intervention under study.

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Section: Joint Involvement Of Family Members and Substance-misusing Rmentioning

confidence: 96%

Family interventions in the treatment of alcohol and drug problems

Copello

Velleman

Templeton

2005

Drug and Alcohol Review

239

157

View full text Add to dashboard Cite

show abstract

“…A welcome development has been reports of a number of new family treatment approaches, including unilateral family therapy (Thomas & Ager, 1993), behavioural couples therapy (Fals-Stewart et al, 1999;O'Farrell & Murphy, 1995), community reinforcement-type family treatment (Miller, Meyers & Tonigan, 1999), network therapy (Galanter, 1999), social behaviour and network therapy (Copello, Orford, Hodgson, Tober, & Barrett, 2002) and the 'pressures to change' method (Barber & Crisp, 1995). While most of those approaches focus on the treatment of relatives' substance problems or on the engagement of relatives in treatment, some have been specifically aimed at responding to the needs of affected family members in their own right.…”

mentioning

confidence: 99%

The 5-Step family intervention in primary care: I. Strengths and limitations according to family members

Orford

Templeton

Patel³

et al. 2007

Drugs: Education, Prevention and Policy

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Background: Family members affected by a close relative's substance misuse constitute a large but neglected, high-risk group. Interventions for that group are now being developed and tested in trials. More use should be made of qualitative methods to study process in such interventions. Design: Semi-structured interviews with family members 12 weeks after assignment to a full or brief 5-Step intervention. Both involved a primary care professional giving a self-help manual, and the full version also involved up to five sessions of a psychosocial intervention. Participants: 143 patients of GPs, health visitors and practice nurses in general practices in two areas of England. Patients were the family members of close relatives with drinking or other drug problems. Analysis: Framework analysis and grounded theory analysis of post-interview reports. Results: There was strong support for a form of intervention that involved face-to-face discussion with a primary care professional, and those who received the full intervention were appreciative of being able to talk to a professional who had time to listen and who appeared interested, understanding and caring. The self-help manual itself was reported to contain active ingredients for change, and a number of family members described transformations in their ways of coping with the problem whether they received the full or brief form of intervention. A common constellation of changes included increased consciousness of the nature and extent of the relative's drinking or drug use and its family effects, an acknowledgement of the family member's own needs and rights, a strengthening of resolve to assert plans and expectations, and a calming effect with reduction in stress symptoms. Many participants were unable to describe changes, however, and the following principal limitations of the intervention were described: prior familiarity with the material, perception that the intervention did not go far enough, belief that it was incapable of effecting change for the substance misusing relative, and a perception that sufficient professional expertise or sympathy was not always available in primary care. Conclusions: Findings suggest that the 5-Step family intervention has positive potential in the primary care setting, but has limitations and may need strengthening for family members whose problems are of longer standing or who have already been exposed to relevant information.

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“…Moreover, only Halford et al (2001) have reported the effects of the interventions on partner violence. Spouses from physically violent relationships have been excluded out of concern that a change in the coping or interactional pattern of the spouse might precipitate a violent reaction in the partner (Thomas & Ager, 1993). Yet, the exclusion of those from violent-partner relationships raises the concern that results may not generalize to a potentially large percentage of individuals with a partner who has alcoholism -more than 50% by some reports (e.g., Gondolf & Foster, 1991).…”

Section: Critique and The Current Studymentioning

confidence: 99%

Coping Skills Training and 12-Step Facilitation for Women Whose Partner Has Alcoholism: Effects on Depression, the Partner's Drinking, and Partner Physical Violence.

Rychtarik

McGillicuddy

2005

Journal of Consulting and Clinical Psychology

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Women (N = 171), distressed from their partners' untreated alcoholism, received either coping skills training (CST), 12-step facilitation (TSF), or delayed treatment (DTC). CST and TSF resulted in lower depression levels than DTC but did not differ from one another. Skill acquisition mediated the treatment effects of CST; Al-Anon attendance did not mediate the TSF effect. Lower depression levels were maintained at 12 months with no differences between groups. Partner drinking decreased from pretreatment to follow-up in the CST and TSF conditions. However, for partners with a history of relationship violence, drinking improved across follow-up in the CST condition but worsened in the TSF condition. Partner relationship violence was less in the CST condition. CST may be particularly useful for women experiencing physical violence from a partner with alcoholism.Women who have a partner with alcoholism have been found to be at greater risk for depression, trauma, and other stress-related disorders and to make greater use of health care services than the general population (Roberts & Brent, 1982;Svenson, Forster, Woodhead, & Platt, 1995). The distress seen in this population most recently has been conceptualized from within a family stress and family interactional model (Hobfoll & Speilberger, 1992;Moos, Finney, & Cronkite, 1990;Orford, 1986;Rychtarik & McGillicuddy, 1997). This model proposes that stress brought on by the negative consequences of the partner's drinking largely accounts for the negative affect experienced in this population. The woman's negative affect, however, is also both directly and indirectly associated with her own coping skills. More effective coping is associated with lower negative affect generally, but it also is hypothesized to have an indirect effect through its negative influence on partner drinking and the buffering (moderating) of partner negative drinking consequences. In this interactive model, however, spouse negative affect is also thought to have a detrimental effect on coping skills (e.g., greater negative affect may interfere with effective coping) and to have a positive impact on the maintenance of the partner's drinking (e.g., greater negative affect in the spouse may increase or help maintain negative affect and continued drinking in the partner).Correspondence concerning this article should be addressed to Robert G. Rychtarik HHS Public Access Author Manuscript Author ManuscriptAuthor Manuscript Author ManuscriptThe literature shows growing empirical support for several of the pathways proposed in this model. The depression and marital distress experienced by women with a partner with alcoholism appear directly related to stress, burden, or extent of problems brought on by their partner's drinking (Moos et al., 1990;Rychtarik & McGillicuddy, 1997;Zweben, 1986). Moreover, in ways consistent with the model, the manner in which individuals cope with these problems appears to influence their own functioning (Moos et al., 1990;Moos, Finney, & Gamble, 1982;Rychtarik & M...

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Unilateral relationship enhancement in the treatment of spouses of uncooperative alcohol abusers

Cited by 47 publications

References 18 publications

Family interventions in the treatment of alcohol and drug problems

Family interventions in the treatment of alcohol and drug problems

The 5-Step family intervention in primary care: I. Strengths and limitations according to family members

Coping Skills Training and 12-Step Facilitation for Women Whose Partner Has Alcoholism: Effects on Depression, the Partner's Drinking, and Partner Physical Violence.

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