Alcoholism, problem drinking or abuse of drinking or drugs is seen as a problem that sits with the abuser. However, more and more research is showing that integrating couples therapy as part of the treatment of the drinking problem is more effective than just having individual counselling for the drinker. A person abusing drinking is living in a system that accommodates the problem behavior whether it is emotional, financially or even from a housing a standpoint. Getting both the problem user or addict and their partner into therapy can look at the dynamics between the two people and see how that system can be changed to facilitate the abuser’s behaviors and choices.
The article by Fals-Stewart, et al., (2005) discusses using couples and family behavioral cognitive therapy (BCT) for treating addiction. Alcoholism has been traditionally seen as an individual problem and treated as such (Fals-Stewart et al., 2005). However, advances in to family and couple’s therapy based on cognitive therapy are seen as one the greatest advances in treating alcoholism according to National Institute on Alcohol and Alcoholism (Fals-Stewart et al., 2005). BCT views treatment that allows for abstinence but does not require it. BCT for alcoholism in couples or family therapy has the most promising research to support its effectiveness of family and couple therapy options (Fals-Stewart et al., 2005).
Other therapies used are Choice Theory and Reality Therapy for treating substance abuse problems in a relationship. This theory emphasizes self-evaluation and helps the individuals in the relationship look at what they want and see if the behaviors they are choosing are effective in getting them what they want. Often when couples start to look at their choices and behaviors and contrast them against what they are actual getting, it can be powerful to look at behavioral changes of one or both parties in the system.
Historically family and couples therapy have not be involved in creating therapies to address addiction. BCT has been in use for over thirty but only recently has research been conducted to assess the efficacy of this approach (Fals-Stewart, et al., 2005). BCT has been shown to be the most effective family and couples treatment to deal with addiction so far of all the family methods assessed (Fals-Stewart, et al., 2005). Choice Theory and Reality Therapy has been used extensively in the addiction community with great results.
Tammy Fontana, MS NCC CTRT
Fals-Stewart, W., O’Farrell, T.J., Birchler, G.R., Cordova, J. & Kelley, M.L. (2005). Behavorial couples therapy for alcoholism and drug abuse: Where we’ve been, where we are and where we are going. Journal of Cognitive Psychotherapy, 19(3), 229.