FAMILIES AND ADDICTION RESEARCH
VA Boston Healthcare System, Brockton Division
Timothy J. O'Farrell, Ph.D., William Fals-Stewart, Ph.D., Christopher Murphy, Ph.D.,
Marie Murphy, Ph.D., Jill Hooley, Ph.D., Rob Rotunda, Ph.D.,
Jane Alter, M.S.W., Michael Feehan, Ph.D., Patrice Muchowski, Sc.D., Arthur Ciaramicoli, Ph.D.
The objectives of this program are to (1) conduct research on family treatment and family processes among individuals with alcoholism and other drug problems; and (2) provide training and clinical services related to this research. Family treatment research has examined behavioral couples therapy (BCT). The program's studies reveal that BCT for alcoholic and drug abusing patients produces better abstinence rates and fewer divorces than individually based treatment. Outcomes after BCT show substantial and significant reductions in domestic violence and very favorable cost benefit and cost-effectiveness results. Ongoing studies of BCT oversample women and minority alcoholic patients to see if earlier positive BCT findings generalize to broader treatment populations and to identify patient characteristics that predict response to BCT in order to develop an algorithm clinicians can use to triage suitable patients to BCT. Another project examines whether a brief family intervention promotes increased aftercare attendance among patients in an inpatient detoxification unit. Family process research targets domestic violence, expressed emotion and other processes (notably those involved in child development). We recently showed that relatives' negative "expressed emotion" (i.e., family criticism) predicts subsequent relapse among alcoholic patients as it does in schizophrenia, mood and eating disorders. We also showed for the first time that domestic violence is reduced after treatment for alcoholism. In fact, violence is almost nonexistent among those alcoholic patients who stay abstinent after treatment. An ongoing project examines the role of couple conflict and domestic violence as both a predictor and outcome of changes in alcohol abuse. Using both treatment and community samples, we are studying the influences of alcohol abuse, domestic violence, and change in these constructs on child behavior and functioning. The aim is to assess for preventive effects for children, over and above treatment effects for parents. Other work examines marital and sexual adjustment in couples with an alcohol or drug dependent member.
Key Words. Addictions, family studies, domestic violence, treatment outcome, child development
Grant Support. NIAAA: R01AA10796, Domestic Violence Among Male Alcoholics in Treatment (TOF); K02AA00234, Programmatic Research on Families and Addiction (TOF); R21AA11735, Brief Family Treatment to Promote Alcoholics' Aftercare; R21AA12433, Domestic Violence Outcomes for Behavioral Couple Therapy (TOF). NIDA: R01DA12189, Behavioral Couples Therapy in Drug Abuse Treatment (WFS-PI, TOF-Co-PI). R01DA14402, Brief Couples Therapy in Drug Abuse Treatment (WFS-PI, TOF-Co-PI).
Program Sites. VA Boston Healthcare System, Brockton Division; AdCare Hospital, Worcester.
Program Director. Timothy J. O'Farrell, Ph.D., Professor of Psychology and Director, Families and Addiction Program, VAMC (116B1), 940 Belmont St., Brockton MA 02301. E-mail timothy_ofarrell@http://hms.harvard.edu
Contact Person. Leslie Reid, Program Administrator, 508-583-4500 ext 3493, Fax 508-895-0235.
Email leslie_reid@http://hms.harvard.edu
Training Opportunities. The program is a training site for the Harvard Medical School Department of Psychiatry NIMH-funded Clinical Research Training Program and other pre- and post-doctoral trainees.
Representative Publications.
O'Farrell, T.J., Hooley, J., Fals-Stewart, W. & Cutter, H.S.G. (1998). Expressed emotion and relapse in alcoholic patients. Journal of Consulting and Clinical Psychology, 66, 744-752.
O'Farrell, T. J., Van Hutton, V., & Murphy, C. M. (1999). Domestic violence after alcoholism treatment: A two-year longitudinal study. Journal of Studies on Alcohol, 60, 317-321.
O'Farrell, T.J. & Fals-Stewart, W. Behavioral couples therapy for alcoholism and drug abuse. (2000). Journal of Substance Abuse Treatment, 18, 51-54.
Murphy, C.M., O'Farrell, T.J., Fals-Stewart, W. & Feehan, M. (2001). Correlates of physical partner assault among male alcoholic patients. Journal of Consulting and Clinical Psychology, 69, 528-540.
Fals-Stewart, W., O'Farrell, T.J. & Birchler, G.R. (2001). Behavioral couples therapy for male methadone maintenance patients: Effects on drug using behavior and relationship adjustment. Behavior Therapy, 32, 787-801.