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Couples Treatment for Drug-dependent Males: Preliminary Efficacy of a Stand Alone Outpatient Model

Epstein, Elizabeth E. PhD* †; McCrady, Barbara S. PhD* †; Morgan, Thomas J. PsyD*; Cook, Sharon M. MS*; Kugler, Greta MS*; Ziedonis, Douglas MD, MPH

Addictive Disorders & Their Treatment: March 2007 - Volume 6 - Issue 1 - p 21-37
doi: 10.1097/01.adt.0000210075.46370.84
Original Articles
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Introduction This study reports on the preliminary efficacy of a stand-alone outpatient model of outpatient Behavioral Couple Therapy for Drug Abuse (BCTD).

Treatment Targeted (1) achieving and maintaining abstinence from substance use, (2) developing spouse skills to cope with drug use, reinforce abstinence, and improve general functioning, and (3) enhancing the marital relationship.

Method Using a methodology we call a “successive cohort design,” 3 waves of couples in which the male was drug dependent were treated in weekly, 6-month outpatient, manual-guided BCTD. Twenty-four couples participated in 2 assessment sessions and began treatment. Participants were assessed at baseline (BL), and 6 and 9 months later, on substance use history, relationship functioning, psychopathology, and psychosocial functioning.

Results From BL to 9 months later, subjects significantly reduced the frequency of drug use days and number of drugs used, and decreased their alcohol use. Fifty-five percent of the men and 24% of the women reported clinically improved marital functioning from BL to 6 months later. From pretreatment to posttreatment, males significantly reduced the number of days that they missed work or had problems with home responsibilities because of drug use. The treatment model seemed to be better suited to White and Latino couples than to Black couples, and to men with no diagnosis of Attention Deficit Hyperactivity Disorder.

Discussion This 20 session BCTD treatment model shows promise for drug-addicted males as an outpatient treatment protocol. Participants reduced drug use, increased relationship satisfaction, reported improved psychosocial functioning, and were satisfied with the treatment they received. Randomized controlled studies are needed to determine the effectiveness of BCTD compared with other models of drug treatment.

*Center of Alcohol Studies, Rutgers, The State University of New Jersey

Department of Psychiatry, University of Medicine and Dentistry of New Jersey, Piscataway, NJ

Supported by a National Institute on Drug Abuse (NIDA) Therapy Development grant DA 10835-03 to the first author.

Reprints: Elizabeth E. Epstein, PhD, Center of Alcohol Studies, 607 Allison Road, Rutgers-The State University of New Jersey, Piscataway, NJ 08854 (e-mail: bepstein@rci.rutgers.edu).

Received for publication December 23, 2005; accepted January 25, 2006

© 2007 Lippincott Williams & Wilkins, Inc.