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An ecological assessment of the efficacy of individual and couples treatment formats of Experiential Systemic Therapy for alcohol dependency Grigg, Darryl Norman


This study investigates the differential treatment efficacy of Experiential Systemic Therapy (ExST) with a comparison treatment called Supported Feedback Therapy (SFT) as it is applied to the problem of alcohol dependency. The inquiry also compares the treatment effectiveness of ExST when offered to the individual alcoholic (ExST-I) and when provided in couples therapy conjoint treatment (ExST-C). An ecological approach to assessment was developed for the investigation. Selfreport questionnaires tapping an array of areas including indices of alcohol use, intrapersonal functioning, couples adjustment, and family characteristics were employed to measure treatment effects from the perspectives of father, mother, and eldest child. Participating families met inclusion criteria including an alcoholic dependent father and a non-alcohol abusing mother in a state of marital distress residing in an intact family situation with at least one child living at home. One hundred and fourteen families were randomly assigned to participating therapists and one of three treatment conditions including ExST-I, ExST-C,or SFT. Therapy was conducted at two out-patient clinics, one located in an urban setting and the other operating in a rural context. Data were collected from all participating families before and after treatment. Data were also gathered at a three month follow-up from participants in the ExST-I and ExST-C treatment conditions. The results of the mixed model multivariate analyses indicated that there were no significant differences between ExST and SFT evident at post-treatment; however, both treatments were found to have promoted highly significant improvements on measures of drinking behavior, intrapersonal symptomology, marital adjustment and family satisfaction. When ExST-I and ExST-C were compared, the results revealed no significant differences between the treatment formats although both parents reported highly significant post treatment changes on all instruments. Additionally, the significant changes associated with ExST-I and ExST-C which were reported by both parents at post-treatment were found to be equally durable at the end of a three month follow-up. The results of the analyses based on the eldest child’s perspective showed that the assessments of family satisfaction were unaffected by the treatment conditions and remained consistent across all measurement occasions. Within system analyses which provided detailed examination of the magnitude of changes reported by both parents at post-treatment were performed. The within system results based on measures probing the assessment domains of alcohol, intrapersonal, couple and family from the father and mother perspectives, revealed that the improvements achieved by the treatments were far reaching and touched a wide array of areas in statistically significant and clinically relevant fashions.

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