Preventing Relapses after Couples' Alcoholism Treatment (McCrady, PI)

The goals of this study are: (1) study ways to improve the maintenance of change initated through outpatient couples treatment for alcoholism; (2) increase the generalizability of the therapy procedures from previous couples treatment research by applying the treatments to a more heterogenous clinical population; (3) begin to identify the active elements in outpatient couples treatment for alcohol abuse and alcoholism; (4) study the relationships between beliefs about drinking and relapses; (5) identify environmental and cognitive variables that predict successful or unsuccessful patient-treatment interactions; (6) study changes in spouse functioning as a result of treatment, and identify environmental and cognitive variables that predict successful or unsuccessful spouse-treatment interactions. Subjects will be 105 male alcoholics and their spouses who meet DSM-III criteria for alcohol abuse and alcohol dependence. Subjects who are psychotic, show evidence of chronic organic brain syndrome, or are physically dependent on other drugs will be excluded. Couples will be randomly assigned to one of 3 experimental conditions: AA/Alanon involvement, Marlatt Relapse Prevention, or a no-maintenance control. All couples will receive standardized treatments for their experimental group. Subjects will be assessed at baseline, at in-person interviews after treatment, at 6, 12, and 18 months after treatment, and through monthly phone calls. Outcome will be measured by assessing: drinking and drug use and problem consequences, psychological functioning, family functioning, physical health, legal and occupational status. Treatment variables and cognitive variables related to relapses, and coping skills will be assessed.