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

Aim. To compare the effectiveness of standard behavioral couples therapy for alcohol problems to two maintenance enhanced therapies. Design. Randomized clinical trial. Setting. Outpatient substance abuse treatment clinic. Participants. Ninety males with alcohol abuse or dependence and their female partners. 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). Findings. 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 drinking and drinking-related consequences. Compared to baseline levels, the percentage of abstinent days increased and heavy drinking days decreased, but the three conditions did not differ. Two outcome variables favored the purely behavioral treatment conditions (ABCT and RP/ABCT) over the AA/ABCT condition: 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 in the AA/ABCT condition. Subjects who complied with post-treatment maintenance plans were more likely to be abstinent than subjects who did not. Conclusions. Results favored the two behavioral conditions and did not suggest additional benefit from combining AA with behavioral couples therapy, bur those who did attend AA showed a positive impact.