SOCIETY LECTURE 2011: Family interventions for alcohol & drug problems

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Dr Barbara McCrady

Distinguished Professor of Psychology and Director of the Center on Alcoholism, Substance Abuse, and Addictions (CASAA), at the University of New Mexico

Barbara S. McCrady, Ph.D. is a Distinguished Professor of Psychology and Director of the Center on Alcoholism, Substance Abuse, and Addictions (CASAA), at the University of New Mexico (Albuquerque, New Mexico, USA).  Prior to 2007 she was the Chair of the Department of Psychology and Clinical Director of the Center of Alcohol Studies at Rutgers University in New Jersey. Dr. McCrady is internationally known for her work in empirically supported treatments for substance use disorders, with a particular focus on conjoint therapy, cognitive behavioral therapy, mutual help groups, and therapies for women. Her research has been funded by the National Institutes of Health (NIH) since 1979, and she currently has NIH support both for her research and to train pre- and post-doctoral fellows for careers in alcohol research.  Dr. McCrady is a Fellow of the Clinical Psychology and Addictions Divisions of the American Psychological Association (APA) and is the Vice-President (President-Elect) of the Research Society on Alcoholism (RSA).  She has served previously as President of Addictions Division 50 of the APA, member of the Board of Directors of the RSA, and Secretary-Treasurer of the Association for Behavioral and Cognitive Therapies. She has served on numerous editorial boards for major journals in psychology and the addictions field, and currently is a senior editor for Addiction. Dr. McCrady has published more than 225 refereed papers, chapters, and books, including treatment manuals and client workbooks for behavioral couple therapy for alcohol use disorders, published by Oxford University Press.



We started our research program with two basic premises:  (a) that families are integrally involved with alcohol and other substance use disorders, and (b) that involving families in treatment could improve outcomes.  In our earliest study, we experimented with jointly admitting persons with alcohol use disorders (AUDs) and their spouses to the hospital for treatment.  From this first study, we learned that family involvement was beneficial, but joint hospitalization was not necessary to effect positive outcomes.  We then developed an outpatient treatment model that drew heavily from behavioral couple therapy and cognitive behavior therapy, Alcohol Behavioral Couple Therapy (ABCT).  In a series of studies, we established that (a) treatment including individual interventions to help the drinker and partners as well as couple-focused interventions resulted in better outcomes in drinking and relationship satisfaction and stability; (b) adding relapse prevention (RP) elements to the treatment provided some additional benefit but combining ABCT with Alcoholics Anonymous did not provide additional benefits; (c) the benefits of ABCT also applied to women with alcohol use disorders; (d) couple therapy was more efficacious than individual therapy for women with other Axis I and Axis II disorders; (e) if given a choice between individual and couple therapy, most women opted for some form of individual treatment.  Given the consistently positive results for couple-involved treatment, we now are expanding our research to test the mechanisms by which we believe ABCT works.  We also are developing a briefer and more flexible treatment that could be used with any family member, are testing a brief intervention for affected families identified in primary care settings.  Finally, we are learning more about the mechanisms by which social support affects alcohol and other substance use disorders, as well as other disease states.


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