Couples therapy is often found to be effective for individuals with substance use problems.
Involvement of a significant other often leads to better outcomes:
- Huge motivation for entering and continuing treatment.
- Lower overall substance use.
- Longer periods of abstinence.
- Better marital functioning.
Substance abuse and marital discord are cyclical:
- Problems in the relationship can lead to substance use. If a relationship becomes dysfunctional – such as with poor communication or problem solving - it can lead to continued or increased substance use.
- Relationship or family conflicts can lead to relapse. The stressors from conflicts can act as a trigger during difficult times.
Behavioral Couples Therapy (BCT) has been found to be the only type of marital intervention empirically supported for its effectiveness with couples.
- Patient and spouse are typically seen together for 12-20 weekly sessions over 3-6 months, aimed at two goals: substance use recovery and enhanced relationship functioning. Recovery is addressed first. We discuss the patterns of substance use and cross-interactions with the relationship.
- Relationship interventions come after maintaining abstinence and the couple is familiar with the session structure. In these sessions we focus on positive feelings, communication skills, and problem solving. Patients develop skills in listening, directly expressing emotions, and negotiation.