SEXUAL ADJUSTMENT OF MALE ALCOHOLICS - CHANGES FROM BEFORE TO AFTER RECEIVING ALCOHOLISM COUNSELING WITH AND WITHOUT MARITAL-THERAPY

Married male alcoholics (N = 36), who had recently begun individual ou tpatient alcoholism counseling, were randomly assigned to a no-marital -treatment control group or to 10 weekly sessions of either a behavior al marital therapy (BMT) or an interactional couples therapy group. Im potence decreased from before to after counseling irrespective of whet her the alcoholic patients received additional marital therapy. Husban ds who received BMT reported increased frequency of wives' orgasm duri ng intercourse and greater increases in satisfaction with the privacy and context of their sexual activities than did couples in the other t wo treatment groups. These findings support a biopsychosocial formulat ion of alcoholics' sexual problems that implicates the physical effect s of acute and chronic alcohol intake as most relevant to the elevated rates of impotence and marital conflict as a major contributing facto r to most sexual problems of alcoholics. The improvement observed in s exual adjustment was rather limited. Despite the improvements in impot ence, the alcoholics still experienced over twice the rate of impotenc e reported by demographically similar nonalcoholics. In terms of sexua l satisfaction, BMT produced only modest gains as viewed by husbands a nd no gains from the wives' perspective. Perhaps sexual adjustment is one of the last areas of the alcoholic's marriage to improve after tre atment. The limited time frame of the present study may have precluded observing further improvements in sexual adjustment that would emerge later after a longer period of recovery. (C) 1998 Elsevier Science Lt d.