Changes in Work Status, Couple Adjustment, and Recovery Capital: Secondary Analysis of Data From a Congruence Couple Therapy Randomized Controlled Trial

Abstract

Purpose: Employment and family/social relationships are 2 of the highest priorities among those in substance use recovery. This study examined the relationship of work status with couple adjustment and other recovery capital treatment outcomes among symptomatic alcohol, substance use, and gambling participants ( N = 38) using data collected in a randomized trial comparing a systemic Congruence Couple Therapy (CCT) and individual-based Treatment-as-Usual (TAU). Method: Change scores and associations between work status and couple adjustment together with 8 other recovery outcome variables at post-treatment (5 months from baseline) and follow-up (8 months from baseline) in TAU ( n = 17) and CCT ( n = 21) were analyzed. Results: Number of those working increased with both CCT and TAU but without reaching significance in either CCT (Cochran’s Q = 5.429, P = .066) or TAU (Cochran’s Q = 2.800, P = .247). Relative to those not working in the combined sample, those working showed significantly improved scores in post-treatment and follow-up in addictive symptoms, couple adjustment, psychiatric symptoms, depression, and life stress. Separating the CCT and TAU groups, similar trend was found in the CCT group but was inconsistent in the TAU group. Conclusion: Significantly greater improvement in addictive symptoms and recovery capital of couple adjustment, mental health, and life stress was found in the working vs not-working group. Compared to individual-based TAU, exploratory findings indicate that the systemic treatment of CCT showed a clearer and more consistent difference in improved working days, addictive symptoms and recovery capital. Replication with larger samples is needed to generalize these results.

Congruence couple therapy for alcohol use and gambling disorders with comorbidities (part I): Outcomes from a randomized controlled trial

“…About 22% reported household income not meeting living needs, 11% reported housing instability, and 35% were not working at the start of the trial. Unemployment posed additional stress to the couple's relationship and increased use of alcohol and/or gambling (Lee & Merali, 2022; Lee & Ofori Dei, 2022). Housing and financial instability were deemed to be negative indicators for engagement in CCT (Shi, 2021).…”

Employment Stress and Couple Adjustment among Clients With Disorders of Gambling and Alcohol Use: Themes of Transfers in Congruence Couple Therapy

“…Convergent findings in a parallel quantitative study drawing from the same RCT support the synchronous effects of work and couple functioning indicating that work status improved with increased couple adjustment, emotion regulation and reduced stress. 47 It further indicated that a systemic approach to treatment such as CCT that targets multiple areas of recovery capital variables is more likely than individually-based treatment to increase employment as measured by working days. 47 The thematic description of this study provides explanation for the correlated changes of couple adjustment, emotion regulation, and reduced stress that occurred with increased working days found in the CCT quantitative study.…”

“…47 It further indicated that a systemic approach to treatment such as CCT that targets multiple areas of recovery capital variables is more likely than individually-based treatment to increase employment as measured by working days. 47 The thematic description of this study provides explanation for the correlated changes of couple adjustment, emotion regulation, and reduced stress that occurred with increased working days found in the CCT quantitative study. CCT enhanced skills and awareness in the couple domain that are transferrable to enhance work-related functioning.…”

“…47 These areas of improvement were related to the increase in working days. 47 Work stress was ameliorated indirectly by the empathy, support, consultation and understanding partners gave to each other. More directly, the addicted individual applied the newly learned skills of congruent communication and awareness of self and other along with increased awareness of family of origin patterns to better respond to stress at work.…”

“…Significant addiction symptom reduction together with improved couple adjustment, emotion regulation and reduced stress with CCT was found among the main RCT outcomes of the same study. 47 These areas of improvement were related to the increase in working days. 47 Work stress was ameliorated indirectly by the empathy, support, consultation and understanding partners gave to each other.…”