The results of multiple studies over the last 25 years indicate that, compared to traditional individual-based treatments, use of Behavioral Couples Therapy (BCT) for married or cohabiting alcoholic and drug-abusing patients results in superior outcomes across multiple domains of psychosocial functioning, including reduced substance use, increased relationship satisfaction, reduced levels of domestic violence, and improved family adjustment. However, despite its demonstrated efficacy, the results of a recent survey indicate BCT is rarely used in community-based substance abuse treatment programs. One of the barriers identified in the survey as interfering with the transfer of BCT from research settings into these programs was that BCT was perceived as costly to deliver, due largely to the staff resources required to provide BCT in the standard conjoint format (i.e., one or two therapists treating a patient and his or her partner for a clinical hour). The mandate for investigators is to develop a version of BCT that is less costly to deliver and yet retains the clinical effectiveness of standard BCT. A potential solution to the problem of the high treatment delivery costs for BCT is to develop a clinically effective version of BCT that can be conducted in a multi-couple group; such a format would allow for the more efficient use of limited staff resources. Thus, the proposed project has two primary aims which will be addressed in two sequential phases. In Phase I, we will develop and refine a 12-session treatment manual for conducting Behavioral Couples Therapy in a group therapy format (G-BCT) for married or cohabiting substance-abusing men and their nonsubstance-abusing intimate female partners. In Phase II of the project, we will conduct a small pilot study in which subjects participating in G-BCT plus Individual Drug Counseling (IDC) will be compared to subjects who participate in an equally intensive Standard BCT (S-BCT) plus IDC and those who receive treatment as usual [i.e., group-based drug abuse counseling (GDQ plus IDC] in terms of clinical outcomes (e.g., substance, dyadic adjustment, family functioning), as well as cost outcomes (e.g., cost-benefit and cost-effectiveness). If the objectives of the proposed study are met, an efficacious variant of BCT would be available that community-based treatment programs could provide using a comparatively efficient delivery format.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA015937-02
Application #
6668728
Study Section
Special Emphasis Panel (ZDA1-KXN-G (06))
Program Officer
Riddle, Melissa
Project Start
2002-09-30
Project End
2006-07-31
Budget Start
2003-08-01
Budget End
2004-07-31
Support Year
2
Fiscal Year
2003
Total Cost
$381,884
Indirect Cost
Name
State University of New York at Buffalo
Department
Type
Organized Research Units
DUNS #
038633251
City
Buffalo
State
NY
Country
United States
Zip Code
14260
Morgan-Lopez, Antonio A; Saavedra, Lissette M; Hien, Denise A et al. (2011) Estimating statistical power for open-enrollment group treatment trials. J Subst Abuse Treat 40:3-17
Morgan-Lopez, Antonio A; Fals-Stewart, William (2008) Consequences of misspecifying the number of latent treatment attendance classes in modeling group membership turnover within ecologically valid behavioral treatment trials. J Subst Abuse Treat 35:396-409
Morgan-Lopez, Antonio A; Fals-Stewart, William (2008) Analyzing data from open enrollment groups: current considerations and future directions. J Subst Abuse Treat 35:36-40
Kelley, Michelle L; Fals-Stewart, William (2008) Treating paternal drug abuse using Learning Sobriety Together: effects on adolescents versus children. Drug Alcohol Depend 92:228-38
Kelley, Michelle L; French, Alexis; Bountress, Kaitlin et al. (2007) Parentification and family responsibility in the family of origin of adult children of alcoholics. Addict Behav 32:675-85
Morgan-Lopez, Antonio A; Fals-Stewart, William (2007) Analytic methods for modeling longitudinal data from rolling therapy groups with membership turnover. J Consult Clin Psychol 75:580-93
Kelley, Michelle L; Fals-Stewart, William (2007) Treating paternal alcoholism with learning sobriety together: effects on adolescents versus preadolescents. J Fam Psychol 21:435-44
Morgan-Lopez, Antonio A; Fals-Stewart, William (2006) Analytic complexities associated with group therapy in substance abuse treatment research: problems, recommendations, and future directions. Exp Clin Psychopharmacol 14:265-73
Fals-Stewart, William; Birchler, Gary R; Kelley, Michelle L (2006) Learning sobriety together: A randomized clinical trial examining behavioral couples therapy with alcoholic female patients. J Consult Clin Psychol 74:579-91
Fals-Stewart, William; Leonard, Kenneth E; Birchler, Gary R (2005) The occurrence of male-to-female intimate partner violence on days of men's drinking: the moderating effects of antisocial personality disorder. J Consult Clin Psychol 73:239-48

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