Extending relapse prevention models to couples

Postmodern Openings , 2019

The purpose of our article is to contribute to the understanding of the mechanisms that intervene in determining the success of abstinence in case of persons suffering from alcohol use disorder (PAUD), a phenomenon that is poorly investigated, but, obviously, extremely important. Based on the database containing 273 Romanian PAUDs, split in three categories according to their abstinence and relapse status (abstinents without any relapses, abstinents with at least one relapse and ex-abstinents that are active consumers nowadays), we have tested several hypotheses derived from the literature, referring to the factors that influence the risk to relapse. The empirical models have shown, in contradiction with plenty of previous research that underline different correlations with the abstinence's durability, that only two factors have a significant impact on the type of abstinence (with or without relapses): marital status and religion. Our research brings up, this way, the significant importance that the relational and normative context and the social support have in assisting the PAUDs who try to fight their addiction.

Neuropsychobiology, 2006

frequency of alcohol intake. These findings suggest that a partnership is more relevant for the risk of relapse than stress coping styles.

Addictive Behaviors, 1988

alcoholics' attributions about their relapses. The subjects were 36 male alcoholic participants in a study of the effectiveness of group behavioral marital therapy (BMT) for alcoholism. Subjects' treatment condition had been determined by random assignment to either the BMT, interactional marital therapy. or control group. At a two year posttreatment follow-up interview, subjects were asked what they thought the main reasons were for starting and stopping drinking in their two most recent relapses.

Alcohol Research & Health, 1999

Relapse prevention (RP) is an important component of alcoholism treatment. The RP model proposed by Marlatt and Gordon suggests that both immediate determinants (e.g., high-risk situations, coping skills, outcome expectancies, and the abstinence violation effect) and covert antecedents (e.g., lifestyle factors and urges and cravings) can contribute to relapse. The RP model also incorporates numerous specific and global intervention strategies that allow therapist and client to address each step of the relapse process. Specific interventions include identifying specific high-risk situations for each client and enhancing the client's skills for coping with those situations, increasing the client's self-efficacy, eliminating myths regarding alcohol's effects, managing lapses, and restructuring the client's perceptions of the relapse process. Global strategies comprise balancing the client's lifestyle and helping him or her develop positive addictions, employing stimulus control techniques and urgemanagement techniques, and developing relapse road maps. Several studies have provided theoretical and practical support for the RP model.

Journal of Substance Abuse Treatment, 1988

The purpose of this paper is to report a descriptive study of the degree of concordance between male alcoholics' and their wives'perceptions of the alcoholics' relapse to drinking within two years of their participation in an outcome study of behavioral marital therapy for alcoholism. At the end of a two-year follow-up period, the 23 alcoholics who had relapsed and their wives were independently interviewed. The results showed that both the alcoholics and their spouses reported both intrapsychic and situationaI determinants of the relapses. Among types of determinants, the situational spouse was reported disproportunately more often by patients and disproportunately less often by spouses. Furthermore, the concordance between patient and spouse reports was low. Use of these findings for marital therapy in the treatment of alcohol abuse is discussed.

Addictive Behaviors, 1983

Pretreatment scores from the drinking-related locus of control scale (DRIE) and reasons for drinking were investigated as predictors of drinking relapse over a nine-month follow-up in a sample of 232 male alcoholics. A significant relationship was found between reasons for drinking and the probability of relapse, with the lowest relapse rates occurring among patients who identified interpersonal conflicts or positive emotional states as the most important reasons for their pretreatment drinking. Results of a reasons for drinking by relapse status ANOVA on DRIE scores revealed no significant main effects. There was. however, a significant interaction. Among patients who attributed their drinking to negative emotional states, those who either relapsed or were lost to follow-up had significantly more external DRIE scores. Among patients who identified negative physical states (i.e., craving) as their primary reason for drinking, relapse or attrition was associated with significantly more internal DRIE scores. Results support assessment of these cognitive social learning constructs for differential treatment planning with patients at increased risk of relapse.

Addictive Behaviors, 1991

Links between social support and relapse were examined in a study of alcoholics, cigarette smokers, and opiate users completing treatment for drug use (N = 221). Subjects were followed weekly until relapse for a maximum of 12 weeks after the end of treatment. Structural and functional social support and support for abstinence and drug use were investigated. With demographic variables and drug-treatment group controlled, greater structural support (as measured by an index of social integration and by partner status) predicted a lower risk of relapse. Greater experienced partner support for abstinence also predicted lower risk. Social network members' use of the subject's problem drug predicted heightened relapse risk, but the effect was not statistically significant. This study contributes to a cross-drug model of relapse. It highlights the importance of social integration and abstinence-specific functional support in predicting the risk of relapse, independent of the particular drug of abuse.

Journal of Studies on Alcohol, 1993

This study evaluated whether alcoholics who received couples relapse prevention (RP) sessions in the year after short-term behavioral marital therapy (BMT) did better than those who did not receive additional RE Couples (n = 59) with an alcoholic husband, after participating in weekly BMT couples sessions for 5 months, were assigned randomly to receive or not receive 15 additional conjoint couples relapse prevention (RP) sessions over the next 12 months. Outcome measures were collected before and after BMT and at quarterly intervals for the year after BMT. Significant improvements in the alcoholics' drinking and the couple's marital adjustment occurred from before to after BMT replicating results of our own and other's earlier studies of BMT with alcoholics, and outcomes remained significantly improved through 12-months follow-up independent of the amount of aftercare received. Given these favorable outcomes overall, the present study provided a stringent test of the hypothesized utility of RE As predicted, alcoholics who received RP after BMT had more days abstinent and fewer days drinking, maintained their improved marriages better and used behaviors targeted by BMT more than those who received BMT alone. The prediction that greater continued use of behaviors targeted by BMT would be associated with better outcomes irrespective of the amount of aftercare received also was supported. The final prediction that couples with more severe alcohol and marital problems at study entry would show the greatest additional benefit from RP was not supported. The relatively clear-cut findings favoring RP may be due to the fact that RP in this study was an intensive, multifaceted booster maintenance intervention delivered in a couples format over a lengthy period of time. Moreover, the present results occurred during the time that couples were still getting RE Limitations to the generalizability and interpretation of the results are discussed. (J. Stud. Alcohol 54: 652-666, 1993) HE Second Special Report to the U.S. Congress on Alcohol and Health (Keller, 1975) called marital and family treatment (MFT) approaches "one of the most outstanding current advances in the area of psychotherapy of alcoholism" (p. 116) and called for controlled outcome studies to evaluate this promising treatment method. In the years since this report, considerable progress has occurred in research on the effectiveness of MFT in alcoholism treatment. Recent reviews of this literature (O'Farrell, 1988, 1989; O'Farrell and Cowles, 1989) have reached three general conclusions. First, studies suggest that intervening with nonalcoholic family members can motivate an initial commitment to change in the alcoholic who is otherwise reluctant to seek

2012

Objective To examine the result of cognitive-behavioral therapy program, with social support, on readiness for early relapse prevention of alcohol use disorder patients. Materials and methods The participants consisted of 59 alcohol use disorder patients, and classified as problem drinker and alcohol dependent. The patients were randomly assigned into experimental (10 problem drinkers and 20 alcohol dependents) and control groups (11 problem drinkers and 18 alcohol dependents). The experimental group received cognitive-behavioral therapy program that was developed by the researcher of 10 activity for 2 weeks. Evaluation for five times were pre-test, post-test and follow up in the first, second and third month by readiness for early relapse prevent questionnaire, and alcohol consumption report. The data were analyzed by utilizing MANCOVA and Chi-square. Results Effect of treatment program on readiness for early relapse prevention were not statistically different in problem drinkers a...

Alcoholism: Clinical and Experimental Research, 2002

Background: The model on which alcohol-related Behavioral Couples Therapy (ABCT) is based posits three primary domains related to alcohol consumption: individual factors, the quality and nature of the spouse's response to alcohol-related situations, and the nature and quality of the couple's marital interactions. Methods: This study tested the model underlying ABCT in a sample of 68 male alcoholics and their partners, who completed at least five sessions of a 15-session outpatient treatment study in which they received ABCT. Couples were assessed at baseline, during treatment, and for 6 months after treatment completion. Stepwise multiple regression was used to test specific predictors derived from the ABCT model. Results: Some support was provided for each component of the ABCT model. Individual drinker variables predicted drinking outcomes, both during and after treatment. Specifically, greater drinking severity and drinking frequency at baseline predicted poorer drinking outcomes. Older client age and more education predicted less frequent but more intense drinking. Spouse coping was related primarily to measures of drinking intensity, rather than drinking frequency. Less intense drinking during treatment was predicted by greater spousal use of problem solving and social support to deal with problems and less use of self-blame, wishful thinking, and avoidance. After treatment, however, spouse coping had a less consistent relationship to drinking intensity. In the marital domain, drinking during treatment was unrelated to pretreatment marital satisfaction measures. However, in the 6 months after treatment, men's ability to remain abstinent was predicted by the quality of the pretreatment marital relationship, and the intensity of their drinking was predicted by the degree of their marital happiness immediately after treatment. Conclusions: Results provided substantial support for the ABCT model, particularly in relationship to the role of the spouse in affecting heavy drinking.