Behavioral couples therapy for comorbid substance use disorders and combat-related posttraumatic stress disorder among male veterans: An initial evaluation

Abstract

Outcomes after behavioral couples therapy (BCT) were compared for 19 dually-diagnosed veterans with combat-related PTSD and a substance use disorder (SUD, primarily alcohol dependence) and 19 veterans with SUD only. Clients with and without comorbid PTSD had very similar pre-treatment clinical profiles on dimensions of substance misuse, relationship functioning, and psychological symptoms. Further, both PTSD and non-PTSD clients showed good compliance with BCT, attending a high number of BCT sessions, taking Antabuse, and going to AA. Finally, both PTSD and non-PTSD groups improved from before BCT to immediately after and 12-months after BCT. Specific improvements noted were increased relationship satisfaction and reductions in drinking, negative consequences of drinking, male-to-female violence, and psychological distress symptoms. Extent and pattern of improvement over time were similar whether the client had PTSD or not. The present results suggest that BCT may have promise in treating clients with comorbid SUD and combat-related PTSD.

Introduction to Special Issue

“…Individuals with SUDs whose families are involved in care are more compliant with treatments and experience more positive outcomes than those who do not have the involvement and support of family members (Rotunda, O'Farrell, Murphy, & Babey, 2008). Yet, lack of information, exclusion from treatment, and inability to contact providers are common complaints of family members who want to provide help (England-Kennedy & Horton, 2011).…”

“Everything that I thought that they would be, they weren’t:” Family systems as support and impediment to recovery

“…Individuals with behavioral health difficulties whose families are involved in care, including but not limited to involvement in family therapy, adhere better to treatment regimens and experience more positive outcomes than those lacking such assistance (Biegel et al ., 2007; Brent & Giuliano 2007; Nelson & Sullivan 2007; Rotunda, et al, 2008). Yet lack of information, exclusion from treatment, and inability to contact providers are common complaints of family members who want to provide help.…”

Correlates of recent and lifetime aggression among Veterans with co-occurring PTSD and substance-use disorders

“…As Moreland and colleagues (2012) illustrate, some reduction in aggression following PTSD treatment has been illustrated, but for some Veterans, aggression continues to remain a challenge following reduction of symptoms commonly correlated with aggression. For example, Rotunda and colleagues (2008) found that in a small preliminary study investigating couples therapy for co-occurring PTSD and SUD among veterans, some couples experienced substantial reductions in male to female intimate partner violence following treatment, but the extent to which this intervention was effective was primarily associated with the Veteran’s PTSD diagnosis. Among civilian populations, literature has illustrated vastly differing typologies and patterns of aggressive behavior (Capaldi & Kim, 2007; Holtzworth-Munroe & Stuart, 1994; Johnson, 2008).…”