A randomized pilot trial of brief family-involved treatment for alcohol use disorder: Treatment engagement and outcomes.

Abstract

Objective: Involving family members in a patient's treatment for alcohol use disorder (AUD) leads to more positive outcomes, but evidence-based family-involved treatments have not been adopted widely in AUD treatment programs. Study aims the following: (a) modify an empirically supported 12-session AUD treatment, alcohol behavioral couple therapy (ABCT) to make it shorter and appropriate for any concerned family member and (b) conduct a small clinical trial to obtain feasibility data and effect size estimates of treatment efficacy. Method: ABCT content was adapted to three-sessions following input from clinicians, patients, and family members. Patient and family member dyads were recruited from an inpatient treatment program and randomized to the new treatment, brief family-involved treatment (B-FIT), or treatment-asusual (TAU). Drinking was assessed using the Form-90; family support and family functioning were assessed using the Family Environment Scale Conflict and Cohesion subscales and the Family Adaptability and Cohesion Evaluation Scale-IV, Communication scale. Dyads (n = 35) were assessed at baseline and 4month follow-up. Results: On average, dyads received one of three B-FIT sessions with 6 dyads receiving no sessions due to scheduling conflicts or patient discharge. At follow-up, there was a large-to-medium effect size estimate favoring B-FIT for proportion drinking days (patient report, n = 22; Hedges' g = 1.01; patient or family report, n = 28; Hedges' g = .48). Results for family support or family functioning measures favored TAU. Conclusions: Implementation of brief family-involved treatment in inpatient AUD treatment was challenging, but preliminary data suggest the potential value of B-FIT in impacting drinking outcomes. Public Health Significance StatementFamily-involved treatments for alcohol use disorders (AUDs) hold considerable promise to improve treatment engagement, compliance, and outcomes. However, these treatments are time-intensive and difficult to learn and to integrate with ongoing clinical treatment. This article reports the development and initial testing a brief, three-session, family-involved treatment that can be incorporated into ongoing AUD treatment. The promising findings suggest that the treatment may increase the efficiency and effectiveness of AUD treatment.