Testing Hypothesized Predictors of Change in Conjoint Behavioral Alcoholism Treatment for Men

Abstract

The model on which alcohol-related Behavioral Couples Therapy (ABCT) is based posits three primary domains related to alcohol consumption: individual factors, the quality and nature of the spouse's response to alcohol-related situations, and the nature and quality of the couple's marital interactions. This study tested the model underlying ABCT in a sample of 68 male alcoholics and their partners, who completed at least five sessions of a 15-session outpatient treatment study in which they received ABCT. Couples were assessed at baseline, during treatment, and for 6 months after treatment completion. Stepwise multiple regression was used to test specific predictors derived from the ABCT model. Some support was provided for each component of the ABCT model. Individual drinker variables predicted drinking outcomes, both during and after treatment. Specifically, greater drinking severity and drinking frequency at baseline predicted poorer drinking outcomes. Older client age and more education predicted less frequent but more intense drinking. Spouse coping was related primarily to measures of drinking intensity, rather than drinking frequency. Less intense drinking during treatment was predicted by greater spousal use of problem solving and social support to deal with problems and less use of self-blame, wishful thinking, and avoidance. After treatment, however, spouse coping had a less consistent relationship to drinking intensity. In the marital domain, drinking during treatment was unrelated to pretreatment marital satisfaction measures. However, in the 6 months after treatment, men's ability to remain abstinent was predicted by the quality of the pretreatment marital relationship, and the intensity of their drinking was predicted by the degree of their marital happiness immediately after treatment. Results provided substantial support for the ABCT model, particularly in relationship to the role of the spouse in affecting heavy drinking.