Behavioral marital therapy with and without additional couples relapse prevention sessions for alcoholics and their...

This study evaluated whether alcoholics who received couples relapse prevention (RP) sessions in the year after short-term behavioral marital therapy (BMT) did better than those who did not receive additional RP. Couples (n = 59) with an alcoholic husband, after participating in weekly BMT couples sessions for 5 months, were assigned randomly to receive or not receive 15 additional conjoint couples relapse prevention (RP) sessions over the next 12 months. Outcome measures were collected before and after BMT and at quarterly intervals for the year after BMT. Significant improvements in the alcoholics' drinking and the couple's marital adjustment occurred from before to after BMT replicating results of our own and other's earlier studies of BMT with alcoholics, and outcomes remained significantly improved through 12-months follow-up independent of the amount of aftercare received. Given these favorable outcomes overall, the present study provided a stringent test of the hypothesized utility of RP. As predicted, alcoholics who received RP after BMT had more days abstinent and fewer days drinking, maintained their improved marriages better and used behaviors targeted by BMT more than those who received BMT alone. The prediction that greater continued use of behaviors targeted by BMT would be associated with better outcomes irrespective of the amount of aftercare received also was supported. The final prediction that couples with more severe alcohol and marital problems at study entry would show the greatest additional benefit from RP was not supported. The relatively clear-cut findings favoring RP may be due to the fact that RP in this study was an intensive, multifaceted booster maintenance intervention delivered in a couples format over a lengthy period of time. Moreover, the present results occurred during the time that couples were still getting RP. Limitations to the generalizability and interpretation of the results are discussed.