Meta-Analysis of Behavioral Couples Therapy for Increasing Abstinence From Substance Use and Relationship Adjustment

Abstract We evaluated the effectiveness of behavioral couples therapy (BCT) on increasing abstinence from substance use and relationship adjustment when compared to alternative treatments. Using meta-analytic procedures, we synthesized 17 randomized, between-group studies representing the data of 2,307 participants (1,304 identified users and 1,003 partners). Abstinence from substance use was measured using the Timeline Followback Interview, while relationship adjustment was measured using the Dyadic Adjustment Scale, the Locke-Wallace Marital Adjustment Test, the Revised Dyadic Adjustment Scale, or the Sexual Adjustment Questionnaire. Separate random-effects meta-analyses revealed small effects sizes in favor of BCT on abstinence from substance use (g = .21 [CI95 = .04, .39]) and relationship adjustment (g = .37 [CI95 = .21, .54]). Independent random-effects models revealed evidence of publication bias and influential moderating variables on treatment outcomes. Counselors should exercise caution when adopting a BCT approach for couples with substance use and relationship adjustment issues, and consider how alternative treatment methods may be just as effective.