Review of Outcome Research on Marital and Family Therapy in Treatment for Alcoholism

Abstract

This review of controlled studies of marital and family therapy (MFT) in alcoholism treatment updates our earlier review (XXXXXXX). We conclude that, when the alcoholic is unwilling to seek help, MFT is effective in helping the family cope better and motivating alcoholics to enter treatment. Specifically, both Al-Anon facilitation and referral and spouse coping skills training (based on new findings) help family members cope better; and Community Reinforcement and Family Training (CRAFT) promotes treatment entry and was successfully transported to a community clinic in a new study. Once the alcoholic enters treatment, MFT, particularly behavioral couples therapy (BCT), is clearly more effective than individual treatment at increasing abstinence and improving relationship functioning. New BCT studies showed efficacy with women alcoholics and with gay and lesbian alcoholics; and BCT was successfully transported to a community clinic, a brief BCT version was tested, and BCT was adapted for family members other than spouses. Future studies should evaluate: MFT with couples where both members have a current alcohol problem and with minority patients, mechanisms of change, transportability of evidence-based MFT approaches to clinical practice settings, and replication of MFT outcomes of reduced partner violence and improved child functioning.

Al-Anon Family Groups: Newcomers and Members

“…This conclusion is based on equivalent or greater improvement in COs' functioning following Al-Anon facilitation or referral than that of waitlist control groups or family-involved treatments. However, no new studies of Al-Anon facilitation and referral have been conducted since 2003 (O'Farrell andClements, 2012). In addition, no previous study has compared the health and coping of Al-Anon newcomers and members, as we did.…”

“…A LCOHOL USE DISORDERS HAVE NEGATIVE consequences for both drinking individuals and their loved ones (Dawson et al, 2007;O'Farrell and Clements, 2012;Rowe, 2012). Poor functioning by the concerned other person (CO) has a negative impact on the drinking individual and may jeopardize recovery (Rowe, 2012).…”

“…Al-Anon Family Groups (Al-Anon), 12-step mutual-help groups for families and friends of problem-drinking individuals, offer help to deal with the impact of another's drinking. Al-Anon is the most widely used form of help for COs in the United States (Miller et al, 1999;O'Farrell and Clements, 2012;O'Farrell and FalsStewart, 2001). Of approximately 24,000 Al-Anon groups in more than 130 countries, approximately 14,000 are in the United States and Canada (http://www.al-anon.alateen.org).…”

Perspective: Beyond the neural circuits

“…The social environment has a significant effect on substance use. Research has demonstrated that marriage and a satisfying marital relationship reduce relapse among men with alcohol dependence and that incorporating relationship counselling into treatment for alcoholism leads to improved outcomes, such as abstinence 4 . Conversely, a critical partner, anger and psychological aggression are associated with poorer outcomes such as relapse 5 .…”

Relationship education for military couples: the development and randomised controlled trial of Couple CARE in Uniform

“…For example, rates of alcohol and other drug misuse in US personnel increase after deployment (Jacobson et al, 2008), and these problems are well-established predictors of relationship dissatisfaction and interpersonal violence (O'Farrell & Clements, 2012). Similarly, the quality of the couple relationship can impact trauma symptoms in military personnel.…”