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“Contrary to conventional wisdom, the authors grab the co-occurring problems by the horns and deal with both at the same time. Their well-organized, scholarly, and pragmatic book tells us exactly how to conduct behavioral couples therapy (BCT). They give us explicit guidelines, materials, and even scripts....Ever mindful of the distinction between effectiveness and efficacy studies in couples therapy, O'Farrell and Fals-Stewart show us how to implement BCT in the real world of clinical practice. Best of all, the appendices contain all kinds of goodies for the novice and expert practitioner: a 12-session BCT manual, posters and forms, and other suggested resources....Clinicians today cannot not deal with substance abuse issues in daily practice—that is why this is a book that should be read, reread, and consulted on a regular basis. Wise practitioners will add Behavioral Couples Therapy for Alcoholism and Drug Abuse to their libraries. Wise clients will seek out the wise therapists who use it.”

—Bulletin of the Menninger Clinic


“A practitioner's guide to using couple therapy, which is likely to be useful to any therapist who works with people with drug or alcohol problems. The two authors are leading researchers in the field and also are clearly very experience therapists....A great strength of the book is that it provides opportunity to adapt the therapy structure and content to different clinical needs....Drs. O'Farrell and Falls-Stewart have done the field a great service providing an accessible manual that describes a humane and flexible approach to offering evidence-based couple therapy. This volume is going on my bookshelf in the 'often used, valuable in clinical practice' section.”

—Drug and Alcohol Review


“This book is a clearly written and very straightforward and stepwise technique-focused approach to the implementation of a scientifically validated approach to behavioral couples therapy (BCT) for addictive disorders....This book is written by two of the top clinical and research psychologists with expertise in family and substance abuse treatment in the world. It is well written and researched and presented in a very usable manner. Its greatest value is that it can provide a beginning family psychologist or other practitioner with a starting point for the initiation of couples and family treatment of substance abusers. It provides a specific, understandable, and usable format with clearly defined techniques and technologies that can be implemented by the graduate-prepared psychotherapist or counselor one week after reading the book. Program directors who need to refine their substance abuse program by implementing session, program, and training structure along with supportive technologies will find this book immensely helpful, affordable, and useful. The book will be a valuable tool for orienting and training new staff who will be providing couples and family therapy in substance abuse programs. It will be handy for faculty teaching introductory substance abuse counseling courses and for supervisors of interns and residents attempting to amass experience and supervision in couples and family treatment with individuals with alcohol and other psychoactive substance abuse problems. It will be helpful in a similar regard to those wishing to have introductory training and supervision in behavioral family therapies. The appendixes alone are worth the price of purchase.”

—PsycCRITIQUES


“In addiction treatment, where practice has lagged so far behind what we know from clinical science, there is, at last, rapid movement toward the use of evidence-based therapies. It is now abundantly clear that treating couples rather than individuals improves outcome, and BCT belongs on any list of evidence-based treatments for addiction. This clearly written book, authored by two highly experienced scientist-clinicians, provides a superb introduction to BCT that is accessible for a broad range of providers. It includes the structured outlines, handouts, and forms that are particularly helpful when learning a new treatment method.”

—William R. Miller, PhD, Departments of Psychology and Psychiatry, (Emeritus), University of New Mexico


“This clearly-written, practical guide to behavioral couples therapy for addictive disorders will be useful to all addiction therapists. Couple-based work is extremely useful in evaluation and treatment of substance abuse; combined with behavioral and coping skills training, it can greatly improve treatment outcomes. Read this book and get better outcomes with your patients!”

—Richard J. Frances, MD, Department of Psychiatry, New York University School of Medicine


“Behavioral couples therapy (BCT) is one of the most scientifically and clinically sound treatments available for alcohol and drug problems. It is a highly cost-effective intervention with beneficial effects on substance abuse recovery, relapse prevention, relationship and family adjustment, and intimate partner abuse. The authors present the conceptual rationale and clinical techniques of BCT in an accessible, practitioner-friendly manner. They provide case examples and clinical wisdom addressing many of the challenges to implementation in real-world settings, including integration with 12-step approaches. This book should prove tremendously helpful in disseminating BCT to educators, researchers, and practitioners, so that a wider segment of the population can experience the benefits of this exemplary treatment approach.”

—Christopher M. Murphy, PhD, University of Maryland, Baltimore County


“Written by the leading clinical researchers in the area, this book is the essential treatment manual for how to conduct behavioral couples therapy for alcoholism and drug abuse. Rich in detail and specific clinical direction, it should occupy a prominent place on the bookshelf of any clinician who treats people with substance abuse problems, or any clinical trainee who aspires to such work.”

—Andrew Christensen, PhD, University of California, Los Angeles


“This excellent, reader-friendly text presents an evidence-based approach that nicely complements and expands a family disease approach to addiction. The text thoroughly addresses drug- and relationship-related issues that emerge during engagement, early recovery, and abstinence maintenance. Readers will find clinical tools like the Recovery Contract particularly helpful. The authors are superb clinical researchers who provide a sound theoretical and empirical rationale for their choice of intervention strategies. Addiction professionals, other mental health professionals, and educators will find this book useful. Its many clear tables and examples of clinical forms make the book particularly suitable for graduate-level courses on addictions treatment.”

—Meredith Hanson, DSW, Fordham University Graduate School of Social Service


“This is an excellent and really valuable book; clearly written, erudite, and immensely useful. The authors are key figures who have done a huge amount to develop behavioral couples therapy (BCT) for substance abuse. BCT is among the most important and effective of a number of current treatments which see substance misuse as occurring within people's social context, rather than as an individual pathology. The book contains a wealth of information, including detailed guidelines that will enable practitioners to use BCT in their everyday clinical practice. I recommend it as a core text for graduate-level training programs in all of the mental health professions.”

—Richard Velleman, PhD, University of Bath, UK

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Table of Contents

1. An Introduction to Behavioral Couples Therapy for Alcoholism and Drug Abuse

2. Engaging the Couple: Initial Couple Sessions

3. Building Support for Abstinence: The Daily Recovery Contract

4. Other Support for Abstinence

5. Increasing Positive Couple and Family Activities

6. Improving Communication, Part I: Listener and Speaker Skills

7. Improving Communication, Part II: Resolving Changes, Conflicts, and Problems

8. Continuing Recovery: Maintenance and Relapse Prevention

9. Challenges in BCT, Part I: Separated and Dual-Problem Couples

10. Challenges in BCT, Part II: Violence and Other Issues

11. Enhancements to BCT

12. Implementing BCT in the Real World

Appendix A. A 12-Session BCT Treatment Manual

Appendix B. Posters Used in BCT

Appendix C. Forms Used in BCT

Appendix D. Suggested Resources

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About the Authors

Timothy J. O’Farrell, PhD, ABPP, is Professor of Psychology in the Department of Psychiatry at Harvard Medical School. He is also Director of the Families and Addiction Program and the Counseling for Alcoholics’ Marriages (CALM) Project at the VA Boston Healthcare System.

William Fals-Stewart, PhD, until his death in 2010, was a principal scientist at RTI International, and Director of the Addiction and Family Research Group.

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Audience

Addiction treatment specialists, clinical and counseling psychologists, clinical social workers, psychiatrists, and couple and family therapists; graduate students and trainees in these areas.