Behavioral couples therapy for alcoholism and drug abuse

Behavioral couples therapy (BCT) sees the substance-abusing patient with th e spouse to arrange a daily "sobriety contract" in which the patient states his or her intent not to drink or use drugs and the spouse expresses suppo rt for the patient's efforts to stay abstinent. BCT also teaches communicat ion and increases positive activities. Research supports three conclusions. First, BCT for both alcoholism and drug abuse produces more abstinence and fewer substance-related problems, happier relationships, fewer couple sepa rations and lower risk of divorce than does individual-based treatment. Sec ond, domestic violence is substantially reduced after BCT for both alcoholi sm and drug abuse. Third, cost outcomes after BCT are very favorable for bo th alcoholism and drug abuse, and are superior to. individual-based treatme nt for drug abuse. The Institute of Medicine (1998) documented a large gap between research and practice in substance abuse treatment. BCT is one exam ple of this gap. BCT has relatively strong research support, but it has not yet become widely used. (C) 1999 Elsevier Science Inc. All rights reserved .