Project CALM: Counseling for Alcoholics' Marriages
| Manual Title |
Project CALM: Counseling for Alcoholics' Marriages |
| Creator |
Timothy J. O'Farrell, Ph.D. |
| Reference |
Rotunda, R. J.,Alter, J. G., & O'Farrell, T. J. (2001).
Behavioral couples therapy for comorbid substance abuse and
psychiatric problems. In M. MacFarlane (Ed), Family therapy
and mental health: Innovations in theory and practice,
(pp.289-309). New York: Haworth.
http://www.bhrm.org/guidelines/couples%20therapy.pdf
This website contains "Behavioral Couples Therapy for Alcoholism
and Drug Abuse," a guideline developed by O'Farrell and Fals-Stewart
for the Behavioral Health Recovery Management Project.
|
| Videotape Resource: |
O'Farrell, T. J. (1994). Behavioral Couples Therapy in Alcoholism
Treatment. VA Medical Center, Brockton, MA. Available from
Timothy J. O'Farrell, Ph.D., Harvard Families and Addition
Program, Harvard Medical School, Dept of Psychiatry at the
VA Boston Healthcare System. 940 Belmont Street (116B1). Brockton,
MA 02301.
|
| Price |
unknown |
| Contact Information: |
Timothy J. O'Farrell, Ph.D., ABPP
Harvard Families and Addiction Program
VA Boston Healthcare (116B1)
Brockton Campus
940 Belmont Street
Brockton, MA 02301
Phone: (508) 583-4500 x3493
Email: timothy_ofarrell@hms.harvard.edu
|
Program Overview:
Note: This is a clinical research program conducted by the Harvard
Medical School Department of Psychiatry and operating in various
sites in Boston.
Theoretical Orientation:
Program draws from a behavioral-cognitive approach.
Program Goals:
To build support for abstinence and improve relationship functioning in married/cohabiting individuals
Phases of Treatment:
- Treatment engagement
- Focus on how patient's addiction affects the family and potential benefits of treatment
- Conjoint couples sessions
- 10-12 weekly sessions, including four key elements:
- Making specific promises (to not threaten divorce, focus on the present; do homework)
- Establish a sobriety contract (either Antabuse or daily sobriety-trust discussions)
- Strengthen the therapeutic relationship
- Provide feedback from assessment and prepare for couples group
- Couples Group
- Group consists of 4-5 couples and a male &female co-therapist
team
- Includes 10 weekly 2-hour sessions
- Group goals include:
- Promote sobriety
- Increase pleasant couple activities (e.g., "caring days")
- Teach communication skills (e.g., listening; expression of positive and negative feelings)
- Negotiate desired behavior changes (e.g., making requests; compromise)
- Plan for maintenance of changes (e.g., relapse prevention)
- Follow-up Contacts
In-clinic or at home visits are conducted quarterly with couple for 2 years after the group ends.
Research:
O'Farrell, Cutter & Floyd (1985)
- Methods: Compared behavioral couples therapy (BCT) combined
with individual counseling for patient TO individual counseling
for patient alone
- Results: Marital outcomes were superior for BCT group
both during and 6-months after treatment. Further, BMT couples
showed significant improvements in both drinking and marital
adjustment in the 2 years after treatment (O'Farrell et al.,
1992)
O'Farrell, Choquette & Cutler (1998)
- Methods: Randomly assigned couples with an alcoholic
husband (who had completed weekly BCT sessions for 5-6 months)
to get or not to get 15 additional couples relapse prevention
sessions over the next year
- Results: Over a 30-month follow-up, relapse prevention
group had more days abstinent, better wives' adjustment, and
longer marriages than traditional BCT group (difference was especially
notable for patients with severe alcohol and marital problems)
Other relevant research findings:
O'Farrell et al(1996):
The average social costs(e.g., healthcare, criminal justice system,
public assistance, etc.) per patient decreased substantially in the
1-2 years after completing the program(average savings of $5,000-$6,500
per patient). Reduced social costs after treatment saved more than
five times the cost of providing the treatment.
O'Farrell et al(2002):
Male-to-female violence decreased significantly in the first and
second year of the program. The decreased prevalence of violence
was especially marked for remitted alcoholics.
Kelley &Fals-Stewart (2002):
Children of alcoholic / drug-abusing fathers who were in BCT improved
more in the yea rafter treatment than children of parents in individual-based
treatment. BCT yielded fewer children who had clinically significant
impairments.
Note: Above description reviewed and approved
by Dr. O'Farrell, 12-9-02 |
