Category: Military and Veterans Psychology

PS5- #A17 - Treatment Retention in Alcohol Behavioral Couple Therapy for Military Personnel

Friday, Nov 17
1:30 PM – 2:30 PM
Location: Indigo Ballroom CDGH, Level 2, Indigo Level

Keywords: Military | Couple Therapy | Addictive Behaviors

PURPOSE. Research on couple therapy for substance use disorders has shown that lower symptom severity, less intimate partner violence, and more satisfying relationships predict lower attrition (Braitman & Kelley, 2016; Graff et al., 2009). The current study explored retention in a pilot cohort of service members/veterans participating in a 15-session military-centric adaptation of an evidenced based Alcohol Behavioral Couple Therapy (ABCT_Mil). METHOD. Eight service members/veterans (all male; mean age 40.88, SD = 13.58) participated with their spouse or romantic partner; of these, 1 couple dropped out before session 1. All measures were collected at baseline and session 1. Alcohol use disorder (AUD) was assessed using the SCID-RV. Drinking (percent drinking days, PDD) for 90 days prior to last drink was assessed using the Timeline Followback. Presence of Post-Traumatic Stress Disorder (PTSD), Traumatic Brain Injury (TBI), Intimate Partner Violence (IPV), and current criminal justice system involvement were assessed via clinical interview. The Beck Depression Inventory, Working Alliance Inventory, Stages of Change Readiness and Treatment Eagerness Scale, and Couple Satisfaction Index_16 were completed. RESULTS. The 7 couples that attended at least one session of ABCT_Mil completed an average of 8.29 (55%) of 15 sessions. Of these 7 couples, 29% (= 2) completed 1-5 sessions, 43% (n = 3) completed 6-10 sessions, and 29% (n = 2) completed 11-15 sessions. Among all 8 couples, every service member/veteran met criteria for AUD, with mean PDD at baseline of 41.55 (SD = 29.51). 75% (n = 6) of service members/veterans presented with PTSD, 37.5% (n = 3) had a history of TBI, and 62.5% (n = 5) reported IPV in the past year. 50% (n = 4) were currently involved in the criminal justice system. The mean depression score was 23.38 (SD = 11.50). Bivariate Pearson correlations showed that number of sessions attended was not associated with age, motivation, therapeutic alliance, depression, couple satisfaction, or PDD. Additionally, T-tests showed that number of sessions attended did not differ between the following subgroups: PTSD (8 sessions attended) v. no PTSD (5 sessions); TBI (6.6 sessions) v. no TBI (8.33 sessions); IPV (7.33 sessions) v. no IPV (7.51 sessions); involvement in criminal justice system (CJS) (10 sessions) and no CJS involvement (4.25 sessions). CONCLUSIONS. Co-morbid PTSD, TBI, IPV, and depression were prevalent in this small pilot cohort of service members/veterans in a larger study adapting and testing Alcohol Behavioral Couple Therapy for military samples. No statistically significant relationships were found between variables tested and treatment retention in a 15 session protocol, perhaps due to small sample size. While not statistically significant, patterns of retention in this small sample suggest that PTSD diagnosis, current involvement in the criminal justice system, and/or higher readiness for change at baseline may be associated with greater retention in treatment in this military sample. Recruitment is currently on-going for the larger study; as additional couples are entered, variables predicting retention will be tracked.

Leela Holman

Graduate Student
Suffolk University
Newton, Massachusetts

Rachel Rosen

Clinical Research Assistant
University of Massachusetts Medical School
Worcester, Massachusetts

Elizabeth Epstein

University of Massachusetts Medical School

David Smelson

University of Massachusetts Medical School

Ayorkor Gaba

Senior Project Director
University of Massachusetts Medical School

Cathryn Glanton Holzhauer

Postdoctoral Research Associate
University of Massachusetts Medical School