Behavioural Couples Therapy

Alcohol problems have a far-reaching effect on partners and families. Therapy with couples or partners – especially behaviourally-oriented therapy – has received considerable empirical support as an adjunct to individual-oriented treatment. Behavioural couples therapy focuses on both the patient and their partner and their communication and social context. It teaches the person who drinks self-management skills and the partner, coping skills. It teaches communication and problem solving skills to reduce conflict and ways of consolidating social support for changes in alcohol use. In behavioural couples therapy, patients and their partner are seen together typically for 12-20 couple sessions usually lasting 90 minutes.  

Feasibility issues are important to consider when offering this treatment. In studies that have evaluated behavioural couples therapy, couples are married or have been cohabiting for at least 1 year and the patient’s partner does not have a substance use disorder. Treatment involving behavioural couples therapy is a more costly intervention, because it is typically delivered in addition to individual psychosocial treatment. Most behavioural couples therapy studies reported a high refusal rate (as high as 75-84%), because the patient did not want their partner involved in treatment, the partner was reluctant to be involved, and/or scheduling challenges. Health practitioners should be aware of these considerations when presenting behavioural couples therapy as a treatment option.