Behavioral Couples Therapy (BCT) is associated with positive outcomes for alcoholic couples, both in terms of reduced alcohol use and increased relationship functioning. In a recent investigation, we showed, for the first time, that married or cohabiting men who primarily abused drugs other than alcohol randomly assigned to participate in BCT (N = 40) reported fewer days of drug use, longer periods of abstinence, fewer drug-related arrests, and fewer drug-related hospitalizations through the 12-month posttreatment follow-up period than husbands randomly assigned to receive individual-based treatment (IBT) only (N = 40). Furthermore, couples who received BCT reported better relationship outcomes, in terms of relationship satisfaction and less time separated, than couples whose husbands received IBT. A cost outcomes analysis revealed BCT was more cost-beneficial and cost-effective than IBT. However, five factors limit the generalizability of these findings: (a) only substance-abusing men with nonsubstance-abusing partners were recruited for the study; (b) it is unclear if the effects observed were due to the BCT interventions or simply the result of attention provided to the spouses; (c) BCT and IBT were provided in the context of a very intensive outpatient program (56 sessions over a 6-month period); (d) a relatively high proportion of participants were mandated by the criminal justice system (i.e., over 80 percent) to engage in and complete treatment; and (e) the participants used in the study were fairly heterogeneous in terms of their substance use backgrounds, which may have added unnecessary sampling variance and thereby reducing statisical power for analyses. The PRIMARY OBJECTIVE of the proposed study is to conduct a randomized clinical trial with 180 married or cohabiting drug- abusing patients and their nonsubstance-abusing partners to examine the comparative clinical efficacy, in terms 1-year posttreatment of drug-using behavior, relationship adjustment (i.e., spousal violence, relationship satisfaction, and stability), and other psychosocial outcomes, of BCT versus (a) and equally intensive IBT for drug-abusing patients only, (b) an equally intensive Psychoeducational Attention Control Condition (PACT) for drug-abusing patients and their partners. The SECONDARY OBJECTIVE is to determine if BCT is more cost-beneficial and cost-effective than IBT or PACT. This Stage II study extends our previous work by (a) including substance-abusing women and their nonsubstance-abusing partners, (b) adding an attention control condition, (c) delivering all interventions in the context of a less intensive overall treatment regimen, and (d) recruiting more homogeneous participants of which a much smaller proportion are mandated to treatment by the legal system.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
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Human Development Research Subcommittee (NIDA)
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Riddle, Melissa
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State University of New York at Buffalo
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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
Andreas, Jasmina Burdzovic; O'Farrell, Timothy J (2009) Alcoholics Anonymous attendance following 12-step treatment participation as a link between alcohol-dependent fathers' treatment involvement and their children's externalizing problems. J Subst Abuse Treat 36:87-100
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

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