Behavioral Couples Therapy

Behavioral Couples Therapy (BCT) is a therapy for drug abusers with partners. BCT uses a sobriety/ abstinence contract and behavioral principles to reinforce abstinence from drugs and alcohol. It has been studied as an add-on to individual and group therapy and typically involves 12 weekly couple sessions, lasting approximately 60 minutes each. Many studies support BCT's efficacy with alcoholic men and their spouses; four studies support its efficacy with drug-abusing men and women and their significant others. BCT also has been shown to produce higher treatment attendance, naltrexone adherence, and rates of abstinence than individual treatment, along with fewer drug-related, legal, and family problems at 1-year followup.

Recent research has focused on making BCT more community-friendly by adapting the therapy for delivery in fewer sessions and in a group format. Research is also being done to demonstrate cost-effectiveness and to test therapy effectiveness according to therapist training.

Further Reading:

Fals-Stewart, W.; Klosterman, K.; Yates, B.T.; O'Farrell, T.J.; and Birchler, G.R. Brief relationship therapy for alcoholism: A randomized clinical trial examining clinical efficacy and cost-effectiveness. Psychology of Addictive Behaviors 19(4):363-371, 2005.

Fals-Stewart, W.; O'Farrell, T.J.; and Birchler, G.R. Behavioral couples therapy for male methadone maintenance patients: Effects on drug-using behavior and relationship adjustment. Behavior Therapy 32(2):391-411, 2001.

Kelley, M. L., and Fals-Stewart, W. Couples- versus individual-based therapy for alcohol and drug abuse: Effects on children's psychosocial functioning. Journal of Consulting and Clinical Psychology 70(2):417-427, 2002.

Klostermann, K.; Fals-Stewart, W.; and Yates, B.T. Behavioral couples therapy for substance abuse: A cost analysis. Alcoholism: Clinical Experimental Research 28(Suppl.):164A, 2004.

Winters, J.; Fals-Stewart, W.; O'Farrell, T.J.; Birchler, G.R; and Kelley, M.L. Behavioral couples therapy for female substance-abusing patients: Effects on substance use and relationship adjustment. Journal of Consulting and Clinical Psychology 70(2):344-355, 2002.

This page was last updated April 2009