Behavioral Couples Therapy for Alcohol Use Disorders

Status: Strong Research Support


Behavioral Couples Therapy for Alcohol use Disorders (ABCT) is an outpatient treatment for individuals with alcohol use disorders and their intimate partners. ABCT is based on four assumptions: (1) intimate partner behaviors and couple interactions can be triggers for drinking; (2) intimate partners can reward abstinence; (3) a positive intimate relationship is a key source of motivation to change drinking behavior; and (4) reducing relationship distress lessens risk for relapse. Using cognitive-behavioral therapy, the ABCT therapist works with both the person who is abusing alcohol and his or her partner to identify and decrease the partner's behaviors that cue or reinforce the client's drinking; strengthen the partner's support of the client's efforts to change through reinforcement of positive change and the use of sobriety contracts; increase positive couple interactions through activities and assignments designed to increase positive feelings and improve constructive communication and problem-solving; and improve the client's coping skills and relapse prevention techniques to achieve and maintain abstinence.

The treatment program consists of 2-3 hours of assessment for treatment planning, followed by 12-20 weekly therapy sessions for the client with his or her partner. Treatment follows cognitive-behavioral principles applied to couples therapy and specific therapeutic interventions for alcohol use disorders. A typical session follows this sequence: (1) the therapist asks about any drinking since the last session; (2) the couple presents and discusses homework assigned at the last session and use of a sobriety contract, if applicable; (3) the couple discusses any drinking or relationship problems since the last session; (4) the therapist presents new material and the couple engages in active learning activities in the session related to the new material; (5) the couple discusses up-coming high risk situations; and (6) the therapist assigns new homework.

The optimal implementation of ABCT occurs in the context of an existing clinic or private practice with certified/licensed mental health or addictions professionals who have a background in treating alcohol use disorders and knowledge of cognitive-behavioral therapy.

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