Common and specific effects of couples treatment for alcoholism: a test of the generic model of psychotherapy.
The generic model of psychotherapy (Orlinsky & Howard, 1987) eschews the view that inputs, processes or outputs associated with treatment exert linear and independent effects on outcomes. Variables within these three clusters must be viewed both within the context of time and through their interactions with other variables within a class. This study illustrates the use of this model by identifying common (comprising both traditional relationship factors and shared therapy ingredients) and specific factors in cognitive-behavioural (CB) and family systems (FS) treatments for alcoholic couples and tracking their contributions over two treatment phases - the acute phase, and the follow-up phase. While four process variables (therapy type, intensity of treatment, common elements and FS-specific procedures) contributed to outcomes during the active treatment phase, these variables became more interactive during follow-up. Indeed, high levels of both specific interventions of both treatments were negatively associated with benefit, if common factors were also frequently used during the acute phase. The best effects were obtained when common and specific interventions were counterbalanced, one being frequently used and the other being infrequently used. Implications for future alcohol treatment and recommendations for research on common and specific factors are discussed.
Harwood
T Mark
TM
Department of Psychology, Humboldt State University, Arcata, CA 95521, USA. tmh29@humbolt.edu
Beutler
Larry E
LE
Castillo
Salvador
S
Karno
Mitch
M
D000328:Adult; D000437:Alcoholism / Q000534:rehabilitation*; D015928:Cognitive Behavioral Therapy; D019546:Couples Therapy; D005196:Family Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D011594:Psychometrics; D011613:Psychotherapy; D016032:Randomized Controlled Trials as Topic