Adapting Alcohol Behavioral Couple Therapy for Service Members in Post-Deployment

Study Overview
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Brief Summary
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The specific aims of the ABCT_Military project are as follows: 1) To modify the existing, Alcohol Behavioral Couple Therapy (ABCT) model to treat service members in the reconstitution (post deployment, reintegration, or separation) stage of service, and develop optional psychoeducation modules to address relevant co-morbid problems and challenges in this population in a weekly, 15 session, stand-alone outpatient format. 2) To test feasibility and preliminary efficacy of the study intervention protocol in a successive cohort design for one cohort of 8 couples and one cohort of 22 couples, with iterative manual revision.

Detailed Description
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The study staff will screen potential participants over the phone, and arrange Baseline (BL) research interviews for appropriate couples. The couple will meet with the program interviewer for approximately 2 hours. After the BL interview, couples will be scheduled to attend therapy sessions. Couples will complete brief within treatment self-report assessments. Couples will complete a post treatment follow up interview four months after session 1.

Official Title
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Adapting Alcohol Behavioral Couple Therapy for Service Members in Post-Deployment

Conditions
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Alcohol Abuse

Intervention / Treatment
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* Behavioral: ABCT_Military


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 18 and older; Married (or separated with efforts to reconcile) or in a committed relationship (cohabiting, or in an exclusive dating relationship), or significant other (SO) (first, second or third degree relative (including step relative or in-law) or close trusted friend not active in same military branch. The service member only must meet the following inclusion criteria: Served or serving in the U.S. Military, Current Alcohol Use Disorder diagnosis, or drink at high risk levels as defined by NIAAA (2010) Exclusion Criteria: Either individual is not fluent in the English language. Exclusion criteria for the service member only: Unstabilized Psychotic disorder in past six months Exclusion criteria for both members of the couple if SO is spouse/romantic partner: Either partner is fearful of participating in couple therapy OR either partner suffered severe physical abuse from partner when perpetrator not intoxicated, in past year

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: ABCT_Military<br>ABCT_Military manual will address alcohol use, couple issues and military specific issues. Required interventions include: routine interventions, overview of treatment, reintegration issues, motivational techniques, patient-focused interventions for abstinence, partner-related interventions for abstinence, couple interventions, general coping skills, social skills and relapse prevention. In addition, to personalize each treatment plan, interventions from optional modules (e.g., intimate partner violence (IPV), depression, trauma, and traumatic brain injury (TBI)) will be integrated into each couple's treatment plan depending on clinical presentation. | Behavioral: ABCT_Military<br>* 15 Weekly Couple Therapy Sessions<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percent Drinking Days (PDD) | Derived from Timeline Followback (TLFB) | Change from baseline at 4 months post Session 1 | 
| Percent Heavy Drinking Days | Derived from Timeline Followback (TLFB) | Change from baseline at 4 months post Session 1 | 
| Mean Drinks Per Drinking Day | Derived from Timeline Followback (TLFB) | Change from baseline at 4 months post Session 1 | 
| Couple Satisfaction Inventory 16 | 16 item measure assessing satisfaction in couple relationship. Scores range from 0 to 81 and higher scores indicate higher levels of relationship satisfaction. Total score is calculated by summing all values. | Change from baseline at 4 months post Session 1 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Coping Strategies Scale | 25-item brief measure assessing coping in alcohol-specific and non-alcohol situations. Scores range from 1-4 and higher scores indicate greater use of coping skills. Total score is calculated by averaging all values. | Change from baseline at 4 months post Session 1 | 
| World Health Quality of Life Questionnaire - Bref | 26-item self report assessing quality of life across 4 domains/subscales: Physical health, Psychological, Social relationships, Environment. The first two items measure quality of life and overall health and are examined separately, with scores ranging from 1-5. The four domain scores are calculated by averaging values and scores range from 1-5. Higher scores indicate higher quality of life within each domain. Mean scores are then multiplied by 4 in order to make domain scores comparable with the scores used in the WHOQOL-100 (full scale measure). | Change from baseline at 4 months post Session 1 | 
| Treatment Services Review | Interview assessing quantity and type of services received (e.g., health, psychological) outside of study intervention. Total scores are calculated by summing the number of outside services used. Total scores have a minimum of 0 and no maximum value. | Weekly during treatment, for up to 16 weeks | 
| Working Alliance Inventory Short Form | 12-item self-report measure of the therapeutic alliance. Total scales are calculated by summing all values. Values range from 1-7 with total scores ranging from 12 to 84). Higher scores indicate greater alliance. | Baseline and through study completion, about 16 weeks | 
| Post-Traumatic Stress Disorder (PTSD) | Percent of sample with a PTSD diagnosis as determined by scores on the Life Events Checklist (LEC-5) and the PTSD Checklist (PCL-5). | Baseline | 
| PTSD Checklist (PCL-5) | 20-item self-report questionnaires assessing current symptoms of PTSD, used to assess current (past 30 days) PTSD severity. Total scores are calculated by summing all values. Scores on the PCL-5 range from 0-80 and reflect a global PTSD severity score, with higher scores indicating greater severity. | Baseline and through study completion, about 16 weeks | 
| Use of Treatment Skills | Self-report questionnaire assessing use of skills learned during treatment. Item scores range from 1-5 and a total score is calculated by summing all values. Higher scores indicate greater use of skills. | Baseline and through study completion, about 16 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Veterans, Cognitive Therapy, Couple Therapy