title: Reducing attrition from conjoint therapy with alcoholic couples.
abstract: Premature termination of treatment by the client has been a pervasive problem in the alcohol treatment field. This drop-out problem is compounded in conjoint therapy for alcoholic couples since most clients typically do not view the drinking problem from a systemic, interactional perspective. Within a short-term communication-interaction based conjoint therapy program offered to couples with an alcohol problem on an outpatient basis, specific mechanisms were developed to deal with client-initiated attrition from treatment. These procedures involve the systematic involvement of the spouse in all aspects of intake, assessment and treatment; the use of role induction in a pretherapy interview; and formal contracting during the beginning phase of therapy. Preliminary results suggest that these efforts may be effective in retaining more socially stable alcoholic clients. For the more transient, less socially stable group of individuals with alcohol-related difficulties, the above mechanisms may not be sufficient to forestall unplanned terminations. It is suggested that the latter group may require help to reduce stresses related to concrete concerns prior to receiving conjoint therapy for their alcohol problem.
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000534:rehabilitation*; D003376:Counseling; D005196:Family Therapy; D005260:Female; D006801:Humans; D008297:Male; D008393:Marriage; D008875:Middle Aged; D010352:Patient Dropouts; D012959:Socioeconomic Factors