Behavioral Couples Therapy for Alcoholism and Drug Abuse

by O'Farrell, Timothy J.; Fals-Stewart, William

• ISBN13: 9781593853242
• ISBN10: 1593853246
• Edition: 1st
• Format: Paperback
• Copyright: 2006-08-16
• Publisher: The Guilford Press

Summary

This eminently practical guide presents an empirically supported approach for treating people with substance abuse problems and their spouses or domestic partners. Behavioral couples therapy (BCT) explicitly focuses on both substance use and relationship issues, and is readily compatible with 12-step approaches. In a convenient large-size format, the book provides all the materials needed to introduce BCT; implement a recovery contract to support abstinence; work with clients to increase positive activities, improve communication, and reduce relapse risks; and deal with special treatment challenges. Appendices include a session-by-session treatment manual and 70 reproducible checklists, forms, and client education posters.

Author Biography

Timothy J. O’Farrell, PhD, ABPP, is Professor of Psychology in the Department of Psychiatry at Harvard Medical School. He is also Director of the Families and Addiction Program and the Counseling for Alcoholics’ Marriages (CALM) Project at the VA Boston Healthcare System.
 
William Fals-Stewart, PhD, is a clinical psychologist, a principal scientist at RTI International, and Director of the Addiction and Family Research Group.

Table of Contents

An Introduction to Behavioral Couples Therapy for Alcoholism and Drug Abuse	1	(26)
What is BCT?	2	(4)
Engaging the Couple and Starting BCT	6	(2)
How BCT Supports Abstinence	8	(2)
How BCT Improves Relationships	10	(2)
Continuing Recovery in BCT	12	(1)
Who Are Appropriate Clients for BCT?	12	(2)
How to be an Effective BCT Counselor	14	(3)
Effectiveness of BCT	17	(1)
Preview of This Book	18	(5)
Frequently Asked Questions	23	(2)
Summary	25	(2)
Engaging the Couple: Initial Couple Sessions	27	(20)
Getting the Patient and Spouse to an Initial Couple Meeting	27	(2)
The Initial Couple Session to Explore the Possibility of Starting BCT	29	(7)
Gaining Commitment and Starting BCT	36	(6)
Typical Sequence and Structure of BCT Sessions	42	(2)
Frequently Asked Questions	44	(1)
Summary	45	(2)
Building Support for Abstinence: The Daily Recovery Contract	47	(28)
Recovery Contract Case Example	47	(2)
Components of the Recovery Contract	49	(1)
Specific Steps to Establish the Recovery Contract	50	(7)
Including Self-Help Meetings and Drug Screens in the Contract	57	(3)
Recovery-Related Medications as Part of the Contract	60	(5)
Common Problems with the Recovery Contract	65	(3)
Overcoming Problems with the Recovery Contract: A Case Example	68	(3)
Frequently Asked Questions	71	(2)
Summary	73	(2)
Other Support for Abstinence	75	(17)
Review Substance Use or Urges to Use Since Last Session	75	(6)
Decrease Exposure to Alcohol and Drugs	81	(2)
Address Stressful Life Problems	83	(3)
Decrease Spouse Behaviors That Trigger or Reward Use	86	(2)
Frequently Asked Questions	88	(2)
Summary	90	(2)
Increasing Positive Couple and Family Activities	92	(20)
Catch Your Partner Doing Something Nice	92	(7)
Shared Rewarding Activities	99	(3)
Caring Day	102	(3)
Case Example	105	(3)
Frequently Asked Questions	108	(2)
Summary	110	(2)
Improving Communication, Part I: Listener and Speaker Skills	112	(25)
Introduction to Communication Skills Training	113	(7)
Communication Sessions	120	(4)
Effective Listening Skills	124	(3)
Effective Speaking Skills: Expressing Feelings Directly Using ``I'' Messages	127	(3)
Case Example	130	(3)
Frequently Asked Questions	133	(2)
Summary	135	(2)
Improving Communication, Part II: Resolving Changes, Conflicts, and Problems	137	(24)
Negotiating Relationship Agreements to Bring About Requested Changes	137	(9)
Conflict Resolution	146	(7)
Problem-Solving Skills	153	(5)
Frequently Asked Questions	158	(1)
Summary	159	(2)
Continuing Recovery: Maintenance and Relapse Prevention	161	(27)
Continuing Recovery Plan	162	(3)
Action Plan to Prevent or Minimize Relapse	165	(9)
Couple Checkup Visits for Continuing Contact	174	(3)
Couples Relapse Prevention Sessions	177	(4)
Couple and Family Issues in Long-Term Recovery	181	(3)
Frequently Asked Questions	184	(2)
Summary	186	(2)
Challenges in BCT, Part I: Separated and Dual-Problem Couples	188	(21)
Couples Who are Separated When You First See Them	189	(4)
Couples Who Separate After Starting BCT	193	(5)
Dual-Problem Couples: Understanding Their Treatment Needs	198	(1)
Dual-Problem Couples: When Both Partners Want to Change	199	(3)
Dual-Problem Couples: When Only One Partner Wants to Change	202	(5)
Frequently Asked Questions	207	(1)
Summary	208	(1)
Challenges in BCT, Part II: Violence and Other Issues	209	(20)
Justification for Using BCT with Violent Couples	209	(7)
Excluding Couples with Very Severe Violence from BCT	216	(3)
Aspects of BCT That AIM to Prevent Violence	219	(1)
Other Challenges	220	(6)
Frequently Asked Questions	226	(1)
Summary	227	(2)
Enhancements to BCT	229	(16)
Combining Parent Skills Training with BCT	229	(4)
BCT as a Method of HIV Risk Reduction	233	(5)
Behavioral Family Counseling: Expanding BCT to Family Members Other Than Spouses	238	(3)
Frequently Asked Questions	241	(1)
Summary	242	(3)
Implementing BCT in the Real World	245	(20)
Settings in Which We Have Used BCT	245	(1)
Conjoint BCT Formats Delivered to One Couple at a Time	246	(4)
Couples Group BCT Formats for Three to Five Couples	250	(3)
Lessons Learned About Barriers to Making BCT an Ongoing Program in Community-Based Clinics	253	(4)
Suggestions For Implementing BCT	257	(4)
Concluding Comments	261	(1)
Summary	262	(3)
Appendices	265	(156)
Appendix A. A 12-Session BCT Treatment Manual	267	(88)
Appendix B. Posters Used in BCT	355	(30)
Appendix C. Forms Used in BCT	385	(34)
Appendix D. Suggested Resources	419	(2)
References	421	(8)
Index	429