| Learning Sobriety Together Toolbox |
TEACH-RIGHT-OUT-OF-THE-BOX. The Learning Sobriety Together Training Kit requires no on-site training, just open the box and begin. We’ve included all the materials necessary to learn and implement Behavioral Couples Therapy at your site: PowerPoint lectures, training video of techniques, research articles supporting the effectiveness of BCT, advertising material (e.g., posters, flyers, handouts), clinical assessment measures, participant workbooks, treatment manuals, and quality assurance measures. Optional on-site training and telephone consultations are also available.
In an effort to enhance the clarity of this section, we’ve broken it down into 3 components: (1) Training; (2) Clinical Application; and (3) Advertising and Promotion. Listed under each heading you’ll find all the materials necessary to get started.
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Training
This section includes all the information and supporting materials needed to thoroughly train your staff.
General certificate programs are available for those interested in pursuing additional training without entering a formal degree program. The Certificate Program in LST provides extensive training in a model with over 25 years of well-documented empirical support and supplements that training with doctoral-level clinical supervision from a world renowned expert in the substance abuse field.
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PowerPoint |
PowerPoint: How to incorporate Behavioral Couples Therapy into your practice
This slide show is designed to introduce participants to the Behavioral Couples Therapy approach. More specifically, the presentation covers the following areas related to BCT: history and research outcomes, essential ingredients, treatment specifications, assessment tools, typical sequence of sessions, and components.
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Video |
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PDF: Manual 6A: Learning Sobriety Together: A BCT Participant's Workbook
This workbook was designed to be used by partners participating in Behavioral Couples Therapy (BCT) as part of treatment for alcoholism or drug abuse.
Manual 6: Learning Sobriety Together: A Couple's Workbook
This workbook was designed to be used by one partner, a couple working together, or for presenters who choose to use the Facilitator’s Guide. |
| Quality Assurance |
Evaluator's Guidebook: In this section you'll find the adherence and competence typically used with this approach. The competence measures will allow you to rate the therapist's competence in providing Behavioral Couples Therapy. Using the adherence measure, you will be able to ascertain how closely he or she adheres to the model. These measures provide a way for clinicians to be certain they are providing the treatment in the manner in which it was intended. |
| Supporting Documentation |
In this section you’ll find exemplars of the paperwork we commonly use in our service provision. This includes: Intake letter, No Show Letter, No Treatment Letter, and Intake Sheet |
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This section includes some of the published articles that nicely describe the BCT approach. Additional articles are located in the bibliography section.
Behavioral Couples Therapy for Substance Abuse:Rationale, Methods, and Findings
Behavioral couples therapy (BCT), a treatment approach for married or cohabiting drug abusers and their partners, attempts to reduce substance abuse directly and through restructuring the dysfunctional couple interactions that frequently help sustain it. In multiple studies with diverse populations, patients who engage in BCT have consistently reported greater reductions in substance use than have patients who receive only individual counseling. Couples receiving BCT also have reported higher levels of relationship satisfaction and more improvements in other areas of relationship and family functioning, including intimate partner violence and children’s psychosocial adjustment. This review describes the use of BCT in the treatment of substance abuse, discusses the intervention’s theoretical rationale,and summarizes the supporting literature.
Behavioral Couples Therapy for Alcoholism and Drug Abuse: Rationale, Methods, Findings, and Future Directions
Behavioral Couples Therapy (BCT) is an evidenced based family treatment for alcoholism and drug abuse. The results of multiple studies conducted during the last 3 decades indicate that participation in BCT by married or cohabiting substance-abusing patients, compared to more traditional individual-based interventions, results in greater reductions in substance use, higher levels of relationship satisfaction, greater reductions in partner violence, and more favorable cost-benefit and cost-effectiveness. This review examines the rationale for using BCT, the empirical literature supporting its use, methods used as part of this intervention, and future research directions.
Brief Relationship Therapy for Alcoholism: A Randomized Clinical Trial Examining Clinical Efficacy and Cost-Effectiveness
The purpose of this study was to examine the clinical efficacy and cost effectiveness of brief relationship therapy (BRT), a shortened version of standard behavioral couples therapy (S-BCT), with alcoholic male patients (N = 100) and their non substance-abusing female partners. Participants were randomly assigned to 1 of 4 treatment conditions: (a) BRT, (b) S-BCT, (c) individual-based treatment (IBT), or (d) psychoeducational attention control treatment (PACT). Equivalency testing revealed that, compared with those assigned to S-BCT, participants who were randomly assigned to BRT had equivalent posttreatment and 12-month follow-up heavy drinking outcomes. Moreover, at 12-month follow-up, heavy drinking and dyadic adjustment outcomes for patients who received BRT were superior to those of patients who received IBT or PACT. BRT was significantly more cost effective than the S-BCT, IBT, or PACT.
Assessing the Costs, Benefits, Cost–Benefit Ratio, and Cost-Effectiveness of Marital and Family Treatments: Why We Should and How We Can
The vast majority of outcome studies examining the effects of marital and family treatments focus exclusively on indicators of and changes in familial functioning and individual members’ psychosocial adjustment, but fail to measure, report, or analyze treatment costs, benefits, cost– benefit ratio, or cost-effectiveness. Because of growing concerns about spiraling
health care costs, clinical and economic outcomes constitute equally important and complementary aspects of any evaluation of marital and family treatments. The twofold purpose of this article is to define different components of cost analyses of health-related interventions, including marital and family treatments, and to describe methods for calculating and integrating clinical and cost outcome information when evaluating marital and family treatments. There are significant opportunities to promote the use of such treatments by conducting and reporting the results of cost analyses.
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Clinical Application |
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This section includes all the materials you’ll need in providing the BCT treatment on a session-by-session basis. |
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In this section you’ll find all the clinical measures typically used as part of BCT. This includes the Marital Happiness Scale, Client Session Report, The Working Alliance Inventory, Dyadic Adjustment Scale, and Response to Conflict Scale.
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Eligibility Sheet
This document is designed to help identify and screen clients that may be eligible for this couples-based treatment.
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Advertising/Promotion |
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This section includes a sample poster we’ve used to advertise the BCT program.
Generic Poster |
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In this section you’ll find a sample flyer to use to market the BCT program to clients.
Generic Flyer |
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In this section you’ll find a detailed description of the Addiction and Family Research Group. In particular, you’ll find information on the origins of the group and our research interests.
In the broadest sense, the mission of the Addiction and Family Research Group (AFRG) is to examine the reciprocal and interactive effects of alcohol and other drug use by individuals from a familial perspective. With this charge, the AFRG explores:
- the emotional, behavioral, and social functioning of the family member or members who use alcohol and other drugs,
- how this use affects other members of the family, and
- how intervention methods (targeted at the individual and the family) may bring about healthful behavioral change.
Our hope is that a greater understanding of these issues will lead to individuals who have problems with alcohol or other drugs, along with their intimate partners and other family members, to work together in achieving abstinence and, in the course of that process, improve their relationships.
Brief Background
With certain exceptions, historically, alcoholism and, by extension, addiction to other psychoactive drugs, have been viewed as individual problems best treated on an individual basis. However, by the early 1970s, there was a growing recognition that the family often plays a crucial role in the etiology and maintenance of substance abuse. In turn, some authors posited that family-involved interventions may be effective in treating alcoholism and drug abuse. In a Special Report to the U.S. Congress in the early 1970s, the National Institute on Alcohol Abuse and Alcoholism described couple and family therapy as "one of the most outstanding current advances in the area of psychotherapy for alcoholism" and called for controlled studies to test the effectiveness of these promising methods (Keller, 1974).
This charge to the research community led to an empirical examination of the efficacy of the marital- and family-based treatments for alcoholism by several different research groups, initially with small-scale studies and, as evidence of effectiveness accumulated, followed by large-scale randomized clinical trials. The pioneering work of Timothy J. O’Farrell, Ph.D. and his Counseling for Alcoholics’ Marriages Project (a.k.a., Project CALM), which is part of the Harvard Families and Addiction Program, revealed robust positive effects of participation in Behavioral Couples Therapy (BCT) for alcoholic patients and their partners, in terms of reduced drinking and improved relationship functioning.
As this programmatic line of research evolved, BCT was successfully used with patients who abused drugs other than alcohol. Additionally, BCT has been applied to different types of substance-abusing couples (e.g., couples with alcoholic and drug-abusing female partners, methadone maintenance patients). Along with substance use and relationship adjustment, interest has also broadened to include the effects of treatment on other outcomes, including child adjustment and intimate partner violence.
Most recently, the principles of BCT have been used as a foundation for the development of other family-focused interventions for the treatment of substance abuse. For example, BCT has been combined with parent skills training to determine if this hybrid treatment (PSBCT) has more positive effects on custodial children than BCT or parent training only. Elements of BCT have also been used with family members other than spouses (parents, siblings) to enhance medication compliance among HIV-positive substance abusers and those substance abusers being treated with naltrexone. Thus, BCT and its variants are now subsumed under the umbrella term Learning Sobriety Together (LST) to capture the broadening of focus from the marital to larger family systems.
Areas of Emphasis
The Addiction and Family Research Group (AFRG) consists of investigators who are primarily (although not exclusively) interested in the effects of alcoholism and drug use on marriage and the family, with an emphasis on the effectiveness of family-involved treatments for these disorders among adults. The AFRG is fundamentally focused on:
- research
- dissemination of findings (via this web site, professional publications and presentations, and other outlets)
- consultation to treatment programs and counselors who are attempting to implement Behavioral Couples Therapy/Learning Sobriety Together into their treatment armamentarium with their substance-abusing patients
William Fals-Stewart, Ph.D., Principal Investigator: Dr. Fals-Stewart is a clinical psychologist with current research and treatment interests that include marital and family therapy with alcohol- and drug-abusing patients, substance abuse treatment cost-outcome and cost-benefits studies, and parent skills training with substance-abusing parents. He has expanded his research to explore issues and potential intervention strategies with families that have a substance-abusing member, such as HIV, interpersonal violence, and psychosocial functioning of children living in these homes.
Dr. Fals-Stewart has authored over 170 academic journal articles and has presented the programs research findings at numerous conferences both nationally and internationally. He has been awarded more than $15 million in supported funding by the National Institute of Drug Abuse (NIDA), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), and the Alpha House Foundation.
Keith Klostermann, Ph.D., Principal Investigator:
Dr. Keith Klostermann is a nationally certified counselor with current research and treatment interests that include marital and family therapy with alcohol- and drug-abusing patients, substance abuse treatment cost-outcome and cost-benefits studies, and parent skills training with substance-abusing parents. In addition, Dr. Klostermann is also interested in issues and potential intervention strategies with families that have a substance-abusing member, such as HIV, interpersonal violence, and psychosocial functioning of children living in these homes. Moreover, Dr. Klostermann serves as a research consultant for several outpatient clinics in the Western New York Region.
Dr. Klostermann has authored a number of articles and chapters and has presented the programs research findings at numerous conferences both nationally and internationally.
Clinically, Dr. Klostermann has assisted in the startup and creation of several school-based family counseling programs in the Western New York area and currently serves as a supervisor and consultant for several of these programs. Dr. Klostermann has extensive experience working with individuals, couples, families, and children, and has presented at national and international conferences.
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