The influence of partner status, relationship quality and relationship stability on outcomes following intensive substance-use disorder treatment.
OBJECTIVE
Addiction treatment studies examining the influence of patients' partners suggest that partner behaviors affect patients' substance-use outcomes. We examine the influence of having a partner at treatment entry as well as the influence of the general quality of support and substance-using status of the partner, on outcomes following treatment for substance-use disorder. We also examine the influence of relationship stability on treatment outcomes and examine baseline partner behaviors that may predict relationship stability.


METHODS
A prospective, intact-group design was utilized with data analyzed using logistic regression. Participants (N = 3,014) from 15 intensive substanceuse disorder treatment programs were assessed at treatment entry and 1-year postdischarge.


RESULTS
Although patients with partners possessed a more favorable clinical profile, their outcomes were no better than those of their single counterparts. However, patients whose relationships lasted through the first year posttreatment had better outcomes than patients whose relationships ended. Relationships with more positive partner behaviors and fewer negative partner behaviors at intake were more likely to remain intact over the course of the first year posttreatment. Positive partner behaviors did not enhance patients' outcomes directly, but partner interpersonal stressors and patients' belief that their partner had a substance-use problem had a significant, deleterious impact on patients' substance-use outcomes.


CONCLUSIONS
Clinicians should routinely assess the quality of patients' relationships with partners. If deleterious partner behaviors exist, empirically supported interventions (e.g., behavioral couples therapy) could be utilized to reduce these behaviors and ultimately reduce relapse risk.
Tracy
Stephen W
SW
Center for Health Care Evaluation, Veterans Affairs Palo Alto Health Care System (MPD-152), Stanford University School of Medicine, 795 Willow Road, Menlo Park, California 94025, USA. stephen.tracy@med.va.gov
Kelly
John F
JF
Moos
Rudolf H
RH
D000328:Adult; D003710:Demography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007398:Interpersonal Relations; D016015:Logistic Models; D008297:Male; D010549:Personal Satisfaction; D011446:Prospective Studies; D055502:Secondary Prevention; D012747:Sexual Partners / Q000523:psychology*; D012923:Social Class; D012944:Social Support; D019966:Substance-Related Disorders / Q000534:rehabilitation*; D013997:Time Factors; D016896:Treatment Outcome