title: A randomized clinical trial of group versus standard behavioral couples therapy plus individually based treatment for patients with alcohol dependence.
abstract: OBJECTIVE
  Multiple studies show that behavioral couples therapy (BCT) is more efficacious than individually based therapy (IBT) for substance use and relationship outcomes among patients with alcohol use disorder. To facilitate dissemination, a multicouple, rolling admission Group BCT (G-BCT) format has been suggested as an alternative to the 1 couple at a time, conjoint Standard BCT (S-BCT) format. This randomized study compared outcomes of G-BCT versus S-BCT over a 1-year follow-up. The authors predicted that G-BCT, as compared to S-BCT, would have equivalent (i.e., noninferior) improvements on substance and relationship outcomes.
  
  
  METHODS
  Participants were patients (N = 101) with alcohol dependence and their heterosexual relationship partners without substance use disorder. Participants were mostly White, in their 40s, and 30% of patients were women. Patients were randomized to either G-BCT plus 12-step-oriented IBT or S-BCT plus IBT. Primary outcomes included Timeline Followback Interview percentage days abstinent and Inventory of Drug Use Consequences measure of substance-related problems. Secondary outcome was Dyadic Adjustment Scale. Outcome data were collected at baseline, posttreatment, and quarterly for 1-year follow-up.
  
  
  RESULTS
  Results overall found no support for the predicted statistical equivalency of G-BCT and S-BCT. Rather than the predicted equivalent outcomes, substance and relationship outcomes were significantly worse for G-BCT than S-BCT in the last 6-9 months of the 12-month follow-up period, because G-BCT deteriorated and S-BCT maintained gains during follow-up.
  
  
  CONCLUSIONS
  This was the first study of the newer rolling admission group format for BCT. It proved to have worse not equivalent outcomes compared to standard conjoint BCT. (PsycINFO Database Record
authors.affiliation: Families and Addiction Program, VA Boston Healthcare System.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: O'Farrell
authors.affiliation: Cincinnati VA Medical Center.
authors.forename: Jeremiah A
authors.initials: JA
authors.lastname: Schumm
authors.affiliation: RTI International.
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Dunlap
authors.affiliation: Families and Addiction Program, VA Boston Healthcare System.
authors.forename: Marie M
authors.initials: MM
authors.lastname: Murphy
authors.affiliation: AdCare Hospital of Worcester, Inc.
authors.forename: Patrice
authors.initials: P
authors.lastname: Muchowski
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000437:Alcoholism / Q000523:psychology / Q000628:therapy*; D001521:Behavior Therapy / Q000379:methods*; D019546:Couples Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011615:Psychotherapy, Group / Q000379:methods*; D016896:Treatment Outcome