Secondary prevention treatment approaches using behavioral self- control strategies have led to reduced alcohol consumption in a variety of treatment samples. However, a substantial percentage of treated subjects remain heavy drinkers at follow-up. Moreover, many studies have failed to examine the extent of posttreatment problems associated with drinking, leaving open the possibility that """"""""successfully"""""""" treated subjects (often defined as consuming fewer than 21 drinks per week ) continue to experience negative drinking consequences. Thus, the efficacy of behavioral self-control strategies might be enhanced with additional treatment components. Efforts to enhance the effectiveness of treatment for alcohol dependent clients have frequently centered on enlisting the assistance and support of those clients' spouses. The present research is designed to examine the effect of spouse involvement and behavioral marital therapy (BMT) in a 10-session drinking moderation program for men and women married problem drinkers without histories of severe physical dependence on alcohol. The problem drinkers will participate in a behavioral drinking moderation program. The problem drinkers will participate in a behavioral drinking moderation program. Their spouses will participate (a) only in the initial and follow-up assessments, (b) with the problem drinkers in the drinking moderation program, or (c) with the problems drinkers in the drinking moderation program and BMT. The problem drinkers and their spouses will be followed for 12 months after the program to broadly assess outcome. It is expected that spouse involvement as part of the drinking moderation program will improve drinking outcome, and that BMT will potentiate the affect of spouse involvement. Another important aim of this project is to further our understanding of the processes by which therapeutic change occurs. The present study will be the first to empirically examine mediators which may play a role in the efficacy of spouse involvement and BMT as well as mediators which may be important in drinking moderation training more generally. The domains of treatment mediators to be investigated are marital variables (e.g., spousal support), alcohol-related variables (e.g., alcohol expectancies), person variables (e.g., assertiveness), and drinking reduction skills. Finally, the project will contribute important information regarding gender differences in problem drinking across a variety of pre- and posttreatment domains, including alcohol, marital and psychiatric functioning and spouse characteristics.
| Walitzer, Kimberly S; Dermen, Kurt H (2004) Alcohol-focused spouse involvement and behavioral couples therapy: evaluation of enhancements to drinking reduction treatment for male problem drinkers. J Consult Clin Psychol 72:944-55 |
