Alcohol abuse.
We reviewed 38 controlled studies of marital and family therapy (MFT) in alcoholism treatment. We conclude that, when the alcoholic is unwilling to seek help, MFT is effective in helping the family cope better and motivating alcoholics to enter treatment. Specifically, (a) Al-Anon facilitation and referral help family members cope better; (b) Community Reinforcement and Family Training promotes treatment entry; and (c) the popular Johnson intervention apparently does not effectively promote treatment entry. Once the alcoholic enters treatment. MFT, particularly behavioral couples therapy (BCT), is clearly more effective than individual treatment at increasing abstinence and improving relationship functioning. BCT also reduces social costs, domestic violence, and emotional problems of the couple's children. Future studies need to specifically evaluate: MFT with women and with minority patients, mechanisms and processes of change, and transportability of evidence-based MFT approaches to clinical practice settings.
O'Farrell
Timothy J
TJ
Harvard Families and Addiction Program, Harvard Medical School Department of Psychiatry at the VA Boston Healthcare System, VAMC-116B1, 940 Belmont St., Brockton, Massachusetts 02301, USA. timothy_ofarrell@hms.harvard.edu
Fals-Stewart
William
W
D000223:Adaptation, Psychological; D000437:Alcoholism / Q000628:therapy*; D001521:Behavior Therapy / Q000379:methods; D019317:Evidence-Based Medicine; D005196:Family Therapy / Q000379:methods*; D006801:Humans