Medaille College, 18 Agassiz Circle, Buffalo, NY 14214, USAUnited States
Enlightened Therapies of Western New York, Williamsville, NY 14221, USAUnited States
Also available as PDF (figures and tables appear in the PDF).
The results of numerous studies over the past four decades have consistently revealed the effectiveness of couple and family-based approaches for drug and alcohol abuse. Behavioral couples therapy (BCT) is a conjoint approach which has been consistently shown to produce fewer substance-related issues, greater abstinence, and improved dyadic functioning compared to individual-based treatments for married and cohabitating couples. The purpose of the present review is to (a) provide the theoretical rationale for the use of couple’s therapy for substance-abusing patients and (b) describe theoretical and practical underpinnings of Behavioral couples therapy for substance use disorders (BCT-SUD) along with key components of this intervention.
Keywords: Couples therapy; Disorders; Treatment; BCT
Couples therapy as an intervention for alcoholism and drug abuse has made substantial strides since its inception in the 1970s. From a clinical vantage point, a fundamental goal for BCT-SUD researchers and clinicians continues to be the transfer of this well-established treatment technology to substance abuse treat ment providers such that BCT will be more available to drug- and alcohol-abusing couples who are likely to benefit from partici pating in the program. Group formats of BCT could potentially aid in dissemination, but research in this area is still in infancy. 1 McGovern et al9 concluded that in order for treatments to be successfully disseminated, investigators must clearly demonstrate the relevance of the treatment to clinicians and staff, even if empirical support is already established. 9 Other factors to consider include degree of difficulty in implementation, how closely (or not) the treatment is aligned with the therapist’s preferred theoretical ori entation or agency counseling approach, cost of providing treat ment, and whether or not the treatment fills a perceived area of need for the clinic. Along these lines, development of web-based BCT-SUD training materials has the potential to reach a much wider audience and be a more cost-effective option. Each of these areas may serve as a potential barrier to successful dissemination of the treatment.
Moreover, substance abuse treatment research is beginning to shift away from a “one-size-fits-all” perspective and move toward adaptive interventions which call for different dosages of treatment to be employed strategically with patients across time dependent on severity of presenting issues and concerns. Given the heterogeneity in patient characteristics and response to treatment, future studies are needed to develop a tailored BCT intervention based on treatment algorithms that dictate treatment modifications triggered by the patient’s initial response and changes in symptom severity.10