Couples Therapy for Addiction

Recruiting at 8 trial locations

Overseen By Myriam Beaulieu, M.Sc.

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Université du Québec à Trois-Rivières

Disqualifiers: Recent treatment, Violence, Active mental disorder, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 18

Duration: 12-16 weeks

100 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial compares two addiction treatments to determine which is more effective: one-on-one therapy or therapy involving both partners in a relationship. The treatments address gambling or substance use issues and aim to improve personal and relationship dynamics. Ideal participants are couples where at least one partner has faced gambling or substance use challenges in the past three months, and both are open to therapy. As an unphased trial, this study allows participants to contribute to valuable research that could enhance addiction treatment options.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What prior data suggests that these treatments are safe for addiction therapy?

Research shows that Integrative Couple Treatment for Addiction (ICT-A) is generally safe for participants. Past studies on similar couple-based therapies found that most people handled the treatment well, with no major safety problems or serious side effects. The treatment involves both partners and aims to improve communication and reduce addiction-related behaviors.

Although the FDA has not yet approved this therapy specifically for gambling or substance use disorders, research suggests it is a well-tolerated option. This information may help potential participants feel more at ease when considering it. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Integrative Couple Treatment for Addiction (ICT-A) because it brings a fresh approach to tackling addictions like gambling and substance use disorders. Unlike standard care, which often involves individual cognitive-behavioral sessions, ICT-A involves both partners in therapy sessions. This method not only focuses on the individual's addiction issues but also aims to improve couple communication and rebuild trust, which can be disrupted by addiction. By involving both partners, ICT-A seeks to reduce unintentional reinforcement of addictive behaviors and enhance the couple's overall relationship satisfaction, potentially leading to more sustainable recovery outcomes.

What evidence suggests that this trial's treatments could be effective for addiction?

Research shows that Integrative Couple Treatment for Addiction (ICT-A), one of the treatments in this trial, can effectively address gambling and substance use problems. Studies on similar couple-based therapies have found that they reduce gambling behaviors and improve relationship satisfaction. One study found that couples participating in a related therapy (ICT-PG) achieved better results than those receiving only individual treatment. In this trial, some participants will receive ICT-A, which helps couples communicate better, reduce harmful behaviors, and increase positive interactions. This comprehensive approach addresses addiction and strengthens the couple's relationship, supporting long-term recovery. ^{1 6 7 8 9}

Who Is on the Research Team?

Joël Tremblay, PhD

Principal Investigator

Université du Québec à Trois-Rivières

Are You a Good Fit for This Trial?

This trial is for couples where one partner has a serious gambling or substance use problem and hasn't had treatment in the last 6 months. They must have lived together for at least half a year or been in a significant relationship for two years. Partners can use substances as long as they're not also highly addicted.

Inclusion Criteria

I have been in a significant relationship for at least 6 months.

Partners can gamble, drink alcohol or use other substances as long as they are not highly addicted to gambling (CPGI≥ 8) or alcohol/substances (ASSIST ≥ 26) and if the partners present a problem to one or the other, it cannot be of moderate level for both issues (score between 3 to 7 from CPGI for gambling, score between 11 to 26 from ASSIST for alcohol, score between 4 to 26 from ASSIST for other substances)

Problem at treatment entry may be gambling or substance use, but it must reach a severity that warrants referral to specialized services (PGSI score ≥8 for GD, ASSIST score ≥26 for alcohol or other substances)

Exclusion Criteria

Disorder or serious mental health unstabilized for one of two members of the couple (History of Psychiatric Hospitalization) in the last 6 months

I have been involved in or a victim of serious domestic violence in the last year.

Scenario with strong suicidal ideation or attempt in the last 30 days or less of two members of the couple (History of Psychiatric Hospitalization)

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive either Integrative Couple Therapy for Addiction (ICT-A) or individual treatment for 12 to 16 sessions

12-16 weeks

12-16 sessions (in-person)

Follow-up

Participants are monitored for addiction severity and various personal and relational outcomes

18 months

Assessments at 6, 12, and 18 months post-admission

What Are the Treatments Tested in This Trial?

Interventions

• Integrative Couple Treatment for Addiction (ICT-A)
• Treatment individual as usually offered

Trial Overview

The study compares Integrative Couple Treatment for Addiction (ICT-A) with standard individual treatment to see which is more effective for those struggling with gambling or substance addiction.

How Is the Trial Designed?

Group I: Integrative Couple Treatment for Addiction (ICT-A) Experimental Treatment 1 Intervention

Inspired by the "Alcohol Behavior Couple Therapy" from Epstein \& McCrady, the ICT-A will be offered over 12 to 16 sessions of 90 minutes. Typically, approximately the first half of each session is dedicated to GD/SUD problems,in a predominantly cognitive behavioral model. In the second part of each session, the clinician will help the couple to improve their communication,to reduce the reinforcements (non-voluntary) of the behaviors of GD/SUD and to increase marital pleasure situations incompatible with the use of GD/SUD.Particular attention will also be paid to feelings of betrayal and interpersonal attacks to restore trust. Plus,they will received a sefl-care guide.

Group II: Individual treatment as usually offered Active Control 1 Intervention

The usual treatment control group will receive individual treatment as already offered by the specialized centres in addiction. For the person with GD/SUD, this treatment consists of 12 to 16 individual cognitive-behavioral sessions of 60 minutes. In general, the intervention aims to secure financial assets, awareness of erroneous thoughts and improvement of alternative skills to gambling in order to meet the normal demands of psychic and relational life. People undergoing this intervention will receive a self-care guide. As for the partners randomized in this intervention, they will receive the services that are usually offered to members of the entourage of a person with GD/SUD. In groups or individually, these services are generally aimed at improving the partner's well-being and relationship with their spouse, which includes information about GD/SUD and the recovery process.

Who Is Running the Clinical Trial?

Université du Québec à Trois-Rivières

Lead Sponsor

Trials

48

Recruited

4,500+

Université de Montréal

Collaborator

Trials

223

Recruited

104,000+

Laval University

Collaborator

Trials

439

Recruited

178,000+

Université de Sherbrooke

Collaborator

Trials

317

Recruited

79,300+

Université du Québec a Montréal

Collaborator

Trials

28

Recruited

5,600+

Published Research Related to This Trial

Integrative couple treatment for pathological gambling (ICT-PG) led to greater improvements in gambling severity and individual well-being compared to individual treatment, with significant reductions in gambling cravings and erroneous beliefs about gambling.

Both treatments resulted in decreased gambling expenses, but ICT-PG was associated with better outcomes for both gamblers and their partners, including reduced depression and increased relationship satisfaction.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of a randomized controlled trial of integrative couple treatment for pathological gambling (ICT-PG): 10-month follow-up. Tremblay, J., Dufour, M., Bertrand, K., et al.[2023]

Behavioral couples therapy (BCT) combined with individually-based therapy (IBT) significantly improved relationship satisfaction and reduced separation rates among drug-abusing women compared to IBT alone, with notable effects observed over a 1-year follow-up.

Both treatment groups showed substantial improvements in substance use outcomes, but those receiving BCT + IBT reported fewer substance-related problems, highlighting the added benefit of incorporating couples therapy in treatment for substance use disorders.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A randomized clinical trial of behavioral couples therapy versus individually-based treatment for drug-abusing women. O'Farrell, TJ., Schumm, JA., Murphy, MM., et al.[2018]

Couple treatment for pathological gambling (ICT-PG) was reported to provide a more positive experience for participants compared to individual treatment, with gamblers and their partners noting improved communication and support in addressing gambling issues.

Participants highlighted that couple therapy facilitated better understanding and prevention of relapse, suggesting that involving partners in treatment can enhance the effectiveness of interventions for pathological gambling.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Experience of Couples in the Process of Treatment of Pathological Gambling: Couple vs. Individual Therapy. Tremblay, J., Dufour, M., Bertrand, K., et al.[2020]

This study will compare the effectiveness of behavioral couples therapy (BCT), which includes concerned significant others (CSOs) in treatment, against individual cognitive-behavioral therapy (CBT) for problem gambling, involving 120 couples.

It is the first research to apply BCT specifically for problem gambling, aiming to assess its impact on gambling behavior and relationship satisfaction over a 12-month period, which could provide new insights into treatment approaches.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of added involvement from concerned significant others in internet-delivered CBT treatments for problem gambling: study protocol for a randomised controlled trial. Nilsson, A., Magnusson, K., Carlbring, P., et al.[2019]

Problem gambling (PG) is identified as a significant family issue that affects couple and family relationships, highlighting the need for therapists to understand its systemic impacts.

There is a lack of training among family therapists in addressing problem gambling, which calls for increased awareness and development of systemic-based treatments to support affected families.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Conceptualizing and treating problem gambling as a family issue. McComb, JL., Lee, BK., Sprenkle, DH.[2018]

Couples therapy (CCT) was found to be more effective than individual treatment-as-usual (TAU) for improving primary outcomes like alcohol use, psychiatric symptoms, and couple adjustment, with medium-to-large effect sizes in a study involving 46 participants over 8 months.

CCT also showed significant improvements in secondary outcomes such as emotion regulation and depression, indicating its potential as a comprehensive treatment for couples dealing with addiction issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Congruence couple therapy for alcohol use and gambling disorders with comorbidities (part I): Outcomes from a randomized controlled trial. Lee, BK., Ofori Dei, SM., Brown, MMR., et al.[2023]

Pathological gambling has significant negative effects on relationships, particularly with spouses, yet most treatment models focus solely on the individual without involving family dynamics.

The proposed Adapted Couple Therapy (ACT) model, developed in collaboration with Québec clinical settings, aims to complement existing individual cognitive-behavioral treatments and may improve outcomes for gamblers by addressing relational issues, potentially reducing dropout rates and relapse.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adapted Couple Therapy (ACT) for pathological gamblers: a promising avenue. Bertrand, K., Dufour, M., Wright, J., et al.[2021]

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