Alcohol-Focused Behavioral Couple Therapy.

Alcohol Behavioral Couple Therapy (ABCT) has emerged over the last 30 years as a highly efficacious treatment for those with alcohol use disorders. This review highlights the historical and conceptual underpinnings of ABCT, as well as the specific treatment elements and structure. Proposed active ingredients, moderators, and mediators of treatment outcome are discussed. Efficacy is evaluated for reductions in identified patient drinking, improved relationship functioning, and reductions in intimate partner violence. Adaptations of ABCT for substances other than alcohol are described. Other adaptations, including brief interventions, interventions addressing PTSD and TBI along with alcohol use, and interventions deliverable via technology platforms are described. Additional cost-benefit and cost-effectiveness findings supporting the economic value of ABCT are noted. Future directions for research in this area include possible adaptations for female identified patients, nontraditional couples, LGBT partners and dyads involving nonintimate partner relationships. The development of more flexible models and enhanced dissemination strategies may improve clinical uptake and utility as well as increasing the feasibility of this treatment for integrated healthcare settings.

A randomized pilot trial of brief family-involved treatment for alcohol use disorder: Treatment engagement and outcomes.

OBJECTIVE: Involving family members in a patient's treatment for alcohol use disorder (AUD) leads to more positive outcomes, but evidence-based family-involved treatments have not been adopted widely in AUD treatment programs. Study aims the following: (a) modify an empirically supported 12-session AUD treatment, alcohol behavioral couple therapy (ABCT) to make it shorter and appropriate for any concerned family member and (b) conduct a small clinical trial to obtain feasibility data and effect size estimates of treatment efficacy. METHOD: ABCT content was adapted to three-sessions following input from clinicians, patients, and family members. Patient and family member dyads were recruited from an inpatient treatment program and randomized to the new treatment, brief family-involved treatment (B-FIT), or treatment-as-usual (TAU). Drinking was assessed using the Form-90; family support and family functioning were assessed using the Family Environment Scale Conflict and Cohesion subscales and the Family Adaptability and Cohesion Evaluation Scale-IV, Communication scale. Dyads (n = 35) were assessed at baseline and 4-month follow-up. RESULTS: On average, dyads received one of three B-FIT sessions with 6 dyads receiving no sessions due to scheduling conflicts or patient discharge. At follow-up, there was a large-to-medium effect size estimate favoring B-FIT for proportion drinking days (patient report, n = 22; Hedges' g = 1.01; patient or family report, n = 28; Hedges' g = .48). Results for family support or family functioning measures favored TAU. CONCLUSIONS: Implementation of brief family-involved treatment in inpatient AUD treatment was challenging, but preliminary data suggest the potential value of B-FIT in impacting drinking outcomes. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

U.S. Principals' Attitudes About and Experiences with Single-Sex Schooling.

Despite a lack of scientific evidence supporting the use of single-sex education, the number of U.S. public schools offering single-sex education has increased. However, our understanding as to why decision-makers have implemented single-sex education is lacking. To address this gap, we surveyed U.S. public-school principals and assessed their attitudes about and experiences with single-sex schooling. Sixty-seven principals from single-sex schools and 193 from coeducational schools participated. The results indicated that principals who had experience with single-sex schooling tended to have more positive attitudes about single-sex schooling, viewed it as more effective, and more often evoked gender-essentialist rationales for the use of single-sex schooling than did coeducational principals. However, both single-sex and coeducational principals noted issues with single-sex schooling. It was concluded that single-sex schooling is not a silver bullet to educational reform and that when single-sex schooling is implemented, one set of issues and problems is substituted for another.

Psychosocial approaches to alcohol use disorders since 1940: a review.

OBJECTIVE: A review of psychosocial approaches to alcohol use disorders (AUDs) was performed to identify and contextualize trends in major treatment approaches and special populations and provide possible future directions for alcohol research. METHOD: The PsycINFO database was searched for peer-reviewed articles relevant to psychosocial approaches to AUDs for each decade since the 1940s, resulting in approximately 4,246 articles for review. Topics were included if they made up at least 4% of the relevant articles for any one decade. Nine treatment and seven special population topics were identified for the current review. RESULTS: Psychoanalytic/psychodynamic and aversion therapies were major topics in the 1940s and 1950s, but few articles have been published recently. Other topics have shown consistent representation in the literature, including criminal justice and military populations, self-help groups, group therapies, couples and family therapies, behavioral treatments and cognitive-behavioral therapy, and complementary/ alternative treatments. The majority of the specific population topics and two newer treatment approaches have appeared more recently in significant proportions, including adolescents, college students, women, ethnic minorities, and dually diagnosed populations; newer treatments include brief interventions and motivational interviewing approaches. CONCLUSIONS: The number of articles on psychosocial approaches to AUDs has been increasing since the 1940s. There have been recent surges in alcohol research on specific populations, an increase in the integration of alcohol treatment with primary care, and a continued emphasis on empirically supported and cost-effective treatments for AUDs; these trends likely will continue into the future.

Psychometric properties of the system for coding couples' interactions in therapy--alcohol.

Few systems are available for coding in-session behaviors for couples in therapy. Alcohol Behavioral Couple Therapy (ABCT) is an empirically supported treatment, but little is known about its mechanisms of behavior change. In the current study, an adapted version of the Motivational Interviewing for Significant Others coding system was developed into the System for Coding Couples' Interactions in Therapy-Alcohol (SCCIT-A), which was used to code couples' interactions and behaviors during ABCT. Results showed good interrater reliability of the SCCIT-A and provided evidence that the SCCIT-A may be a promising measure for understanding couples in therapy. A 3-factor model of the SCCIT-A (Positive, Negative, and Change Talk/Counter-Change Talk) was examined using a confirmatory factor analysis, but model fit was poor. Because model fit was poor, ratios were computed for Positive/Negative ratings and for Change Talk/Counter-Change Talk codes based on previous research in the couples and Motivational Interviewing literature. Post hoc analyses examined correlations between specific SCCIT-A codes and baseline characteristics, and indicated some concurrent validity. Correlations were run between ratios and baseline characteristics; ratios may be an alternative to using the factors from the SCCIT-A. Reliability and validity analyses suggest that the SCCIT-A has the potential to be a useful measure for coding in-session behaviors of both partners in couples therapy and could be used to identify mechanisms of behavior change for ABCT. Additional research is needed to improve the reliability of some codes and to further develop the SCCIT-A and other measures of couples' interactions in therapy.