Does enhanced social support improve outcomes for problem drinkers in guided self-change treatment?

Although social support has been repeatedly identified as a strong correlat e of recovery from alcohol problems, enhancing social support has seldom be en a focus of treatment research. Married problem drinkers who were willing to have their spouses involved in their treatment were randomly assigned a mong two brief outpatient treatment conditions: directed social support (DS , n = 28) and natural social support (NS, n = 28). In both conditions the t reatment in which the problem drinkers participated was an identical progra m of guided self-change, a cognitive-behavioral motivational intervention i nvolving an assessment and four individual treatment sessions, Problem drin kers' spouses each attended two individual counseling sessions where they w ere informed about the counseling procedures. The conditions differed in th at spouses in the DS group were encouraged to play an active role in helpin g their partner by being supportive and particularly by reacting to relapse episodes in a manner consistent with a relapse prevention model. One year follow-up found that participants in both groups improved significantly fro m pretreatment to the end of treatment, and that the gains were maintained over follow-up. The two groups did not differ significantly from one anothe r at any point in time. Possible explanations for the results include that (a) the baseline level of social support in this population may have create d a ceiling effect, and (b) the prognosis for this population may be so pos itive that it is difficult to demonstrate significant enhancement of outcom es. (C) 2000 Elsevier Science Ltd. All rights reserved.