Publication year
2015
Citation Title
Couple treatment for alcohol use disorder and posttraumatic stress disorder: Pilot results from U.S. military veterans and their partners
Journal Name
Journal of Traumatic Stress
Journal Volume
28
Issue Number
3
Page Numbers
247-252
DOI
10.1002/jts.22007
Summary
Posttraumatic stress disorder (PTSD) and heavy alcohol use can be common among military Veterans. As a first partner-involved treatment, this pilot study assessed pre- and post-scores of Veterans and their partners on measures related to alcohol use, PTSD, depression, and relationship satisfaction. Findings revealed significant reductions in PTSD symptoms, depression, and amount of alcohol consumption each day.
Key Findings
Following participation in the couple’s therapy treatment, eight Veterans reported significant reductions in PTSD symptoms.
The percentage of days spent heavily drinking among Veterans was significantly reduced.
Four Veterans and three partners reported a decrease in depression in post-assessment of the treatment.
Relationship satisfaction of three Veterans and four partners was improved following couple’s therapy.
Implications for Program Leaders
Educate professionals who serve Service members and their families on recognizing the signs of PTSD and alcohol use disorders
Develop workshops for Service members and their families on effective ways to reduce problematic alcohol use and PTSD, while also improving relationship satisfaction
Offer support groups for family members of Service members with PTSD and other substance use disorders that promote healthy coping and family well-being
Implications for Policy Makers
Encourage partnering with Veteran Affairs (VA) to help Service members and their families deal with PTSD and other substance use disorders
Recommend that programs for Service members leaving the military provide information about VA benefits for Veterans
Encourage awareness campaigns on and off installations regarding the importance of mental health and relationship well-being
Methods
Participants were recruited from the Cincinnati Veterans Affairs PTSD program and the alcohol use disorder treatment program.
Couples completed pre-treatment and post-treatment assessments six to seven weeks following participation in the couples’ treatment for alcohol use disorder and PTSD; a 15-session psychotherapy.
Depression, PTSD symptoms and severity, substance use behaviors, and relationship satisfaction were assessed among the Veterans and their partners.
Differences in changes from pre- to post-treatment were assessed for both Veterans and their partners.
Participants
Male Veterans (N = 13) and their female partners participated in this study; with an average of nine years cohabitating as a couple.
Average age among Veterans and partners was 40 years (Veterans M = 42.22, SD = 16.14; partners M = 39.33, SD = 12.64).
Racial composition of the sample included: seven White Veterans, six White partners, six Black Veterans, six Black partners, and one partner who was multiracial.
Limitations
Only 13 participants participated in this study, which limits the ability to generalize the findings to the general population of Veterans and their partners.
The findings are limited to Veterans with primary alcohol use disorder and PTSD, thus the findings cannot be generalized to Veterans with other substance use disorders.
The study only collected data at two time points and was a pilot study, which limits the ability to determine if the treatment was helpful to Veterans and the partners over a longer period of time.
Avenues for Future Research
Further this pilot study with a larger sample of Veterans and partners
Utilize samples that include Veterans and their partners with various substance use disorders to determine how the treatment may be helpful to reducing use and symptoms from each disorder
Evaluate the effectiveness of the treatment at multiple time points and across time among Veterans and their partners
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Military Component
Abstract
We studied 13 U.S. male military veterans and their female partners who consented to participate in an uncontrolled trial of couple treatment for alcohol use disorder and posttraumatic stress disorder (CTAP). CTAP is a 15-session, manualized therapy, integrating behavioral couples therapy for alcohol use disorder (AUD) with cognitive_behavioral conjoint therapy for posttraumatic stress disorder (PTSD). Due to ineligibility (n = 1) and attrition (n = 3), 9 couples completed the study, and 7 completed 12 or more sessions. There were 8 veterans who showed clinically reliable pre- to posttreatment reduction of PTSD outcomes. There were also significant group-level reductions in clinician-, veteran-, and partner-rated PTSD symptoms (d = 0.94 to 1.71). Most veterans showed clinically reliable reductions in percentage days of heavy drinking. Group-level reduction in veterans’ percentage days of heavy drinking was significant (d = 1.01). There were 4 veterans and 3 partners with clinically reliable reductions in depression, and group-level change was significant for veterans (d = 0.93) and partners (d = 1.06). On relationship satisfaction, 3 veterans and 4 partners had reliable improvements, and 2 veterans and 1 partner had reliable deterioration. Group-level findings were nonsignificant for veteran relationship satisfaction (d = 0.26) and for partners (d = 0.52). These findings indicate that CTAP may be a promising intervention for individuals with comorbid PTSD and AUD who have relationship partners.
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