| Out of the Box |
TEACH-RIGHT-OUT-OF-THE-BOX. Strengthening families, couples, and individuals promotes healthy relationships and provides a better quality of life for people. The materials listed in this section are designed to positively impact marriage and couples relationships, resulting in greater well-being for individuals, families, communities, and society. We’ve included all the materials necessary to learn and implement this Marital Education Program at your site: PowerPoint lectures, advertising material (e.g., posters, flyers, handouts), clinical assessment measures, participant workbooks, and instructional manuals. Optional on-site training and telephone consultations are also available.
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Training
General certificate programs are available for those interested in pursuing additional training without entering a formal degree program. The Certificate Program in LST provides extensive training in a model with over 25 years of well-documented empirical support and supplements that training with doctoral-level clinical supervision from a world renowned expert in the substance abuse field. |
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Manual 6: Learning Sobriety Together: A Couple's Workbook
This workbook was designed to be used by one partner, a couple working together, or for presenters who choose to use the Facilitator’s Guide.
This program is a collection of information, skills, and lessons learned from years of research that has been used directly with couples in our BCT programs who have reported struggles in their relationship and family as a result of a substance use problem. Countless couples and families have benefited from learning about and using the very skills and information that are presented in this program. Work in this area has shown that people can change behavior which results in change in other aspects of their lives; specifically, their intimate relationships and the functioning and well-being of the whole family. This skills-based program addresses issues of substance abuse, relationship distress, family conflict, and communication problems. How substance abuse relates to HIV and interpersonal violence is also discussed. Furthermore, each section provides the reader with a number of strategies and skills that can be implemented to address these very common concerns. The overarching goal of this program is to assist couples in gaining a greater understanding of substance abuse and various methods and tools for supporting sobriety. This program requires active participation on the part of the couple(s) and/or the facilitator. Thus, there are a number of exercises that help couples work through and practice each skill as it is introduced.
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These articles provide a general overview of substance use and its effects.
"Co-Morbid Anxiety and Substance Use Disorders: Theoretical and Treatment Issues"
OCD is a surprisingly common co-occurring disorder among patients with substance abuse. However, it is a disorder that often goes undetected by those without specific background and training in OCD and its diagnosis, assessment, and treatment. With proper screening, however, OCD can be readily identified. More importantly, OCD appears to exacerbate substance abuse; thus, treating both concurrently is likely to lead to better outcomes than a sequential treatment approach. Although the behavioral treatments for OCD, particularly ERP, are quite different than those typically used for substance abuse, making their integration difficult, the good news is that there are effective treatments for both disorders. Moreover, there is evidence that a combined treatment approach for both disorders, as described herein, can effectively be used to treat substance-abusing patients with OCD. Thus, when clinicians find themselves confronted with these patients, there is good hope for a positive outcome, both in terms of OCD symptoms and substance use behavior.
Intimate partner violence and alcohol use: Exploring the role of
drinking in partner violence and its implications for intervention
A large and growing empirical literature reveals a robust relationship between alcohol use and the occurrence of intimate
partner violence (IPV). However, the role of alcohol use and intoxication in episodes of IPV, particularly with respect to
alcohol's potential causal or facilitative function in the occurrence of partner aggression, remains a source of much
controversy and considerable debate. The purpose of this review is to (a) describe briefly IPV and the types of behaviors
subsumed under this label, (b) examine evidence for the link between alcohol use and IPV, (d) explicate factors (e.g.,
antisocial personality disorder) that may moderate this relationship, and (e) discuss the primary conceptual models put forth to
explain this association. Recommendations for interventions that consider the relationship between alcohol use and IPV are
also provided.
Treating Substance Abuse and Intimate Partner Violence:
Implications for Addiction Professionals
As counselors in substance abuse treatment programs begin using evidence-based
marital and family-based interventions with their clients, they frequently encounter
one of the most emotionally charged public health issues of our time: intimate partner
violence (IPV). Unfortunately, the prevalence of partner aggression among married
or cohabiting substance-abusing clients is alarmingly high. For married or cohabiting
clients entering treatment for alcoholism, the proportion reporting at least one
episode of IPV in the previous year has ranged from 40-60 percent across several
studies, which is 4-6 times higher than observed in national samples (e.g.,
Fals-Stewart, 2003; O’Farrell & Murphy, 1995). |
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UNDER DEVELOPMENT
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This section includes a sample poster we’ve used to advertise the BCT program.
UNDER DEVELOPMENT
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UNDER DEVELOPMENT |
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In this section you’ll find a detailed description of the Addiction and Family Research Group. In particular, you’ll find information on the origins of the group and our research interests.
In the broadest sense, the mission of the Addiction and Family Research Group (AFRG) is to examine the reciprocal and interactive effects of alcohol and other drug use by individuals from a familial perspective. With this charge, the AFRG explores:
- the emotional, behavioral, and social functioning of the family member or members who use alcohol and other drugs,
- how this use affects other members of the family, and
- how intervention methods (targeted at the individual and the family) may bring about healthful behavioral change.
Our hope is that a greater understanding of these issues will lead to individuals who have problems with alcohol or other drugs, along with their intimate partners and other family members, to work together in achieving abstinence and, in the course of that process, improve their relationships.
Brief Background
With certain exceptions, historically, alcoholism and, by extension, addiction to other psychoactive drugs, have been viewed as individual problems best treated on an individual basis. However, by the early 1970s, there was a growing recognition that the family often plays a crucial role in the etiology and maintenance of substance abuse. In turn, some authors posited that family-involved interventions may be effective in treating alcoholism and drug abuse. In a Special Report to the U.S. Congress in the early 1970s, the National Institute on Alcohol Abuse and Alcoholism described couple and family therapy as "one of the most outstanding current advances in the area of psychotherapy for alcoholism" and called for controlled studies to test the effectiveness of these promising methods (Keller, 1974).
This charge to the research community led to an empirical examination of the efficacy of the marital- and family-based treatments for alcoholism by several different research groups, initially with small-scale studies and, as evidence of effectiveness accumulated, followed by large-scale randomized clinical trials. The pioneering work of Timothy J. O’Farrell, Ph.D. and his Counseling for Alcoholics’ Marriages Project (a.k.a., Project CALM), which is part of the Harvard Families and Addiction Program, revealed robust positive effects of participation in Behavioral Couples Therapy (BCT) for alcoholic patients and their partners, in terms of reduced drinking and improved relationship functioning.
As this programmatic line of research evolved, BCT was successfully used with patients who abused drugs other than alcohol. Additionally, BCT has been applied to different types of substance-abusing couples (e.g., couples with alcoholic and drug-abusing female partners, methadone maintenance patients). Along with substance use and relationship adjustment, interest has also broadened to include the effects of treatment on other outcomes, including child adjustment and intimate partner violence.
Most recently, the principles of BCT have been used as a foundation for the development of other family-focused interventions for the treatment of substance abuse. For example, BCT has been combined with parent skills training to determine if this hybrid treatment (PSBCT) has more positive effects on custodial children than BCT or parent training only. Elements of BCT have also been used with family members other than spouses (parents, siblings) to enhance medication compliance among HIV-positive substance abusers and those substance abusers being treated with naltrexone. Thus, BCT and its variants are now subsumed under the umbrella term Learning Sobriety Together (LST) to capture the broadening of focus from the marital to larger family systems.
Areas of Emphasis
The Addiction and Family Research Group (AFRG) consists of investigators who are primarily (although not exclusively) interested in the effects of alcoholism and drug use on marriage and the family, with an emphasis on the effectiveness of family-involved treatments for these disorders among adults. The AFRG is fundamentally focused on:
- research
- dissemination of findings (via this web site, professional publications and presentations, and other outlets)
- consultation to treatment programs and counselors who are attempting to implement Behavioral Couples Therapy/Learning Sobriety Together into their treatment armamentarium with their substance-abusing patients
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