Behavioral Couples Therapy for Substance Use Disorders: Recommendations for Implementation

In Behavioral Couples Therapy (BCT) is a theoretically-based, manualized, and an empirically supported treatment based on social learning theory which posits that distressed couples engage in interaction patterns characterized by punishment rather than mutual positive reinforcement behaviors. BCT was originally designed for a marital family model of general psychotherapy; however, in the past 4 decades, BCT has proven to be effective for the treatment of conjoint alcoholism and substance abuse. Despite empirical data demonstrating positive outcomes with this population, BCT has not been widely accepted in community-based alcoholism and drug abuse treatment. Implementation of new treatments, like BCT, often fail due to a lack of careful consideration as to whether the necessary resources, timing, and commitment of staff and management are present to launch the treatment process into action for full operational execution. A successful implementation process requires a cultural shift within and throughout the agency. Recommendations for implementation of BCT for community-based agencies are presented along with several reasons why implementation often fails.

Keywords: Behavioral couples therapy; Dissemination; Implementation