Maintaining change after conjoint behavioral alcohol treatment for men: outcomes at 6 months

Aim. To compare the effectiveness of standard behavioral couples therapy fo r alcohol problems to two maintenance enhanced therapies. Design. Randomize d clinical trial. Setting. Outpatient substance abuse treatment clinic. Par ticipants. Ninety males with alcohol abuse or dependence and their female p artners. Interventions. Weekly, outpatient therapy in one of three randomly assigned conditions: Alcohol Behavioral Couples Therapy (ABCT), Alcoholics Anonymous plus ABCT (AA/ABCT) or Relapse Prevention plus ABCT (RP/ABCT). F indings. The men significantly reduced the frequency of drinking and heavy drinking during treatment. During the first 6 months post-treatment, 65.7% of male subjects were classified as improved on a composite measure of drin king and drinking-related consequences. Compared to baseline levels, the pe rcentage of abstinent days increased and heavy drinking days decreased, but the three conditions did not differ. Two outcome variables favored the pur ely behavioral treatment conditions (ABCT and RP/ABCT) over the AA/ABCT con dition: time to the first heavy drinking day was longer for subjects in the ABCT condition than subjects in the AA/ABCT condition, and subjects in the RP/ABCT condition tended to have shorter drinking episodes than subjects i n the AA/ABCT condition. Subjects who complied with post-treatment maintena nce plans were more likely to be abstinent than subjects who did not. Concl usions. Results favored the two behavioral conditions and did not suggest a dditional benefit from combining AA with behavioral couples therapy, bur th ose who did attend AA showed a positive impact.