Involving the spouse or other family members in the alcoholic patient's treatment generally is considered an effective means to promote alcoholism recovery. For example, the PI's work on behavioral couples therapy (BCT) shows that BCT is effective with married/cohabiting alcoholic patients and their relationship partners who are willing to take part in a relatively intensive outpatient spouse-involved program. But what about the broader range of alcoholic patients who live or have close contact with family members other than a spouse (e.g., parents, siblings) or patients who are eligible for but unwilling to use BCT or similar methods? Some of the most intriguing and potentially widely applicable family treatment methods involve brief intervention with family members at key times in the patients' addictions treatment to promote continued use of treatment. Two types of brief family interventions show promise in pilot studies and correlational data on alcoholic patients: aftercare contracts in which family members reinforce the patient's continuation in treatment after an initial brief inpatient or day rehab program; and family assessment interviews to aid treatment planning in short-term intensive inpatient or day treatment. The proposed project will use these two brief intervention methods as the basis to develop and pilot test a brief family treatment to promote continued aftercare by alcoholic patients. This R21 developmental project has 2 phases. Phase 1, which involves treating 15 cases in a treatment development process, aims to develop (1) a treatment manual for a brief family intervention with alcoholics during short-term intensive outpatient or day treatment when the alcoholic patient is deciding what additional outpatient aftercare treatment to pursue; and (2) procedures to ensure and measures to assess therapists' adherence to and competence in using the treatment manual. Phase 2 will conduct a randomized pilot study with 48 cases in which participants will be randomly assigned to (a) treatment as usual (TAU, n=24) or (b) TAU plus brief family intervention (n=24). Outcome data will be collected at baseline and at 3 and 6 month follow-up. Phase 2 aims to test the prediction that alcoholic patients who receive a brief family intervention in addition to TAU, as compared with their counterparts who get TAU alone, will immediately enter and attend outpatient aftercare to a greater extent; and in the following 6 months have lower frequency and fewer negative consequences of alcohol and drug use, less inpatient and more outpatient treatment utilization, and better individual and family adjustment.

National Institute of Health (NIH)
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Exploratory/Developmental Grants (R21)
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Health Services Research Review Subcommittee (AA)
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Lowman, Cherry
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Harvard University
Schools of Medicine
United States
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