title: A qualitative investigation of barriers to entry into couples' treatment for alcohol problems.
abstract: This study used qualitative methodology to evaluate barriers to entry into couples' treatment for alcohol problems. Data were collected using semistructured interviews. Patients were recruited from (a) treatment for primary substance use disorders, (b) treatment for psychiatric disorders (other than substance use disorders), and (c) court-mandated outpatient domestic violence programs. Mental health experts were recruited based on expertise in (a) couples' treatment, (b) alcohol treatment, and (c) couples' treatment for alcohol problems. Patients (N = 57) met criteria for hazardous drinking and were in committed romantic relationships. Partners (n = 19) and mental health experts (n = 12) also completed interviews. Interviews were analyzed using accepted qualitative strategies. Barriers to treatment entry were identified at the patient, partner, and couple level. Barriers identified included psychological barriers, alcohol illness factors, treatment preferences and beliefs, and interpersonal factors. Although many barriers are similar to those previously identified in individual alcohol treatment, barriers unique to couples' treatment provide guidance for next directions for dissemination.
authors.affiliation: Butler Hospital, Warren Alpert Medical School of Brown University, Providence, RI 02906, USA. Yael_Chatav_Schonbrun@Brown.edu
authors.forename: Yael Chatav
authors.initials: YC
authors.lastname: Schonbrun
authors.forename: David R
authors.initials: DR
authors.lastname: Strong
authors.forename: Terrie
authors.initials: T
authors.lastname: Wetle
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Stuart
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000473:pathology / Q000523:psychology* / Q000628:therapy*; D003144:Communication Barriers; D017579:Domestic Violence / Q000517:prevention & control / Q000523:psychology*; D005191:Family Characteristics; D005239:Fear; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D007398:Interpersonal Relations; D007406:Interview, Psychological; D008297:Male; D001523:Mental Disorders / Q000473:pathology / Q000523:psychology / Q000628:therapy*; D012747:Sexual Partners; D019966:Substance-Related Disorders / Q000473:pathology / Q000523:psychology* / Q000628:therapy*