Skip to main content

Advertisement

Log in

Behavioral Couples Treatment for Substance Use Disorder: Secondary Effects on the Reduction of Youth Internalizing Symptoms

  • Published:
Journal of Abnormal Child Psychology Aims and scope Submit manuscript

A Correction to this article was published on 18 October 2018

This article has been updated

Abstract

This study examined the secondary effects of Behavioral Couples Treatment (BCT) for parents with substance use disorder on youth reports of internalizing symptoms (i.e., depressive and anxiety symptoms). Participants were 59 triads (father, mothers, and youth; 32 girls, 27 boys) in which one or both parents met criteria for drug or alcohol use disorder (or both). Mothers, fathers, and youth completed pretreatment, post-intervention, and 6-month post-intervention follow-up assessments. Two piecewise latent growth models examined whether number of sessions attended was associated with parents’ relationship satisfaction or its growth over time, and in turn if parents’ relationship satisfaction was uniquely associated with youth depressive/anxiety symptoms or their growth over time. A significant indirect effect at post-intervention revealed the number of sessions attended contributed to decreases in youth depressive symptoms via increases in mothers’ and fathers’ relationship satisfaction. Mothers’ relationship satisfaction uniquely mediated the relationship between number of sessions attended and youth depressive symptoms at post-intervention. With regards to fathers, there was a non-significant trend such that increases in sessions attended was associated with decreases in youth depressive symptoms post- intervention via increasing relationship satisfaction among fathers. Findings suggest that BCT may have protective secondary effects in reducing youth reports of depressive symptoms among couples in which one or both parents have substance use disorder.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Change history

  • 18 October 2018

    The authors would like to note a couple of errors in Table 3 of the originally published manuscript.

  • 18 October 2018

    The authors would like to note a couple of errors in Table 3 of the originally published manuscript.

  • 18 October 2018

    The authors would like to note a couple of errors in Table 3 of the originally published manuscript.

References

  • Andreas, J. B., & O’Farrell, T. J. (2007). Longitudinal associations between fathers’ heavy drinking patterns and children’s psychosocial adjustment. Journal of Abnormal Child Psychology, 35, 1–16. doi:10.1007/s10802–006–9067-2.

    Article  PubMed  Google Scholar 

  • Ashery, R. S., & McAuliffe, W. E. (1992). Implementation issues and techniques in randomized trials of outpatient psychosocial treatments for drug abusers: Recruitment of subjects. The American Journal of Drug and Alcohol Abuse, 18, 305–329. doi:10.3109/00952999209026069.

    Article  PubMed  Google Scholar 

  • Bonds, D., & Gondoli, D. M. (2007). Examining the process by which marital adjustment affects maternal warmth: The role of coparenting support as a mediator. Journal of Family Psychology, 21, 288–296. doi:10.1037/0893–3200.21.2.28.

    Article  PubMed  Google Scholar 

  • Bountress, K., & Chassin, L. (2015). Risk for behavior problems in children of parents with substance use disorders. American Journal of Orthopsychiatry, 85, 275–286. doi:10.1037/ort0000063.

    Article  PubMed  Google Scholar 

  • Brock, R. L., & Kochanska, G. (2015). Decline in the quality of family relationships predicts escalation in children’s internalizing symptoms from middle to late childhood. Journal of Abnormal Child Psychology, 43, 1295–1308. doi:10.1007/s10802–015–0008-9.

    Article  PubMed  PubMed Central  Google Scholar 

  • Carroll, K. M., & Onken, L. S. (2005). Behavioral therapies for drug abuse. The American Journal of Psychiatry, 162, 1452–1460. doi:10.1176/appi.ajp.162.8.1452.

    Article  PubMed  PubMed Central  Google Scholar 

  • Cummings, E. M., & Davies, P. T. (2010). Marital conflict and children: An emotional security perspective. New York: The Guildford Press.

    Google Scholar 

  • Davies, P. T., & Cicchetti, D. (2004). Toward an integration of family systems and developmental psychopathology approaches. Development and Psychopathology, 16, 477–481. doi:10.1017/0S0954579404004626.

    Article  PubMed  Google Scholar 

  • DiNitto, D. M., Webb, D. K., & Rubin, A. (2002). The effectiveness of an integrated treatment approach for clients with dual diagnoses. Research on Social Work Practice, 12, 621–641. doi:10.1177/1049731502012005003.

    Article  Google Scholar 

  • Drapkin, M. L., McCrady, B. S., Swingle, J. M., & Epstein, E. E. (2005). Exploring bidirectional couple violence in a clinical sample of female alcoholics. Journal of Studies on Alcohol, 66, 213–217. doi:10.15288/jsa.2005.66.213.

    Article  PubMed  Google Scholar 

  • Efron, B., & Tibshirani, R. J. (1993). An Introduction to the bootstrap. Boca Raton: CRC Press.

    Book  Google Scholar 

  • Emery, R. E. (1999). Marriage, divorce, and children’s adjustment (2nd ed.). Thousand Oaks: Sage.

    Google Scholar 

  • Enders, C. K. (2001). The impact of nonnormality on full information maximum-likelihood estimation for structural equation models with missing data. Psychological Methods, 6, 352–370. doi:10.1037/1082-989X.6.4.352.

    Article  PubMed  Google Scholar 

  • Enders, C. K., & Bandalos, D. L. (2001). The relative performance of full information maximum likelihood estimation for missing data in structural equation models. Structural Equation Modeling, 8, 430–457. doi:10.1207/S15328007SEM0803_5.

    Article  Google Scholar 

  • Epstein, E. E., McCrady, B. S., Morgan, T. J., Cook, S. M., Kugler, G., & Ziedonis, D. (2007). Couples treatment for drug-dependent males: Preliminary efficacy of a stand along outpatient model. Addictive Behaviors & Their Treatment., 6, 21–37. doi:10.1097/01.adt.0000210075.46370.84.

    Article  Google Scholar 

  • Erceg-Hurn, D. M., & Mirosevich, V. M. (2008). Modern robust statistical methods: an easy way to maximize the accuracy and power of your research. American Psychologist, 63, 591–601. doi:10.1037/0003-066X.63.7.591.

    Article  PubMed  Google Scholar 

  • First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (2010). Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Non-patient Edition (SCID-I/NP). New York: Biometrics Research, New York State Psychiatric Institute.

    Google Scholar 

  • Fritz, M. S., & MacKinnon, D. P. (2007). Required sample size to detect mediated effect. Psychological Science, 18, 233–239. doi:10.1111/j.1467–9280.2007.01882.x.

    Article  PubMed  PubMed Central  Google Scholar 

  • Gaunt, R., & Scott, J. (2014). Parents’ involvement in childcare: Do parental and work identities matter? Psychology of Women Quarterly, 38, 475–489. doi:10.1177/0361684314533484.

    Article  Google Scholar 

  • Hayes, A. F. (2009). Beyond baron and Kenny: statistical mediation analysis in the new millennium. Communication Monographs, 76, 408–420.

    Article  Google Scholar 

  • Homish, G. G., Leonard, K. E., & Cornelius, J. R. (2008). Illicit drug use and marital satisfaction. Addictive Behaviors, 33, 279–291. doi:10.1016/j.addbeh.2007.09.015.

    Article  PubMed  Google Scholar 

  • Hussong, A. M., Flora, D. B., Curran, P. J., Chassin, L. A., & Zucker, R. A. (2008). Defining risk heterogeneity for internalizing symptoms among children of alcoholic parents. Developmental Psychopathology, 20, 165–193. doi:10.1017/S0954579408000084.

    Article  Google Scholar 

  • Kane, P., & Garber, J. (2004). The relations among depression in fathers, children’s psychopathology, and father-child conflict: A meta-analysis. Clinical Psychology Review, 24, 339–360. doi:10.1016/j.cpr.2004.03.004.

    Article  PubMed  Google Scholar 

  • Katz, L. F., & Gottman, J. M. (1993). Patterns of marital conflict predict children’s internalizing and externalizing behaviors. Developmental Psychology, 29, 940–950. doi:10.1037/0012-1649.29.6.940.

    Article  Google Scholar 

  • Kearney, M. H., Murphy, S., & Rosenbaum, M. (1994). Mothering on crack cocaine: A grounded theory analysis. Social Science & Medicine, 38, 351–361. doi:10.1016/0277–9536(94)90405–7.

    Article  Google Scholar 

  • Kelley, M. L., Klostermann, K., Doane, A., Mignone, T., Lam, W. K. K., Fals-Stewart, W., & Padilla, M. A. (2010). The case for examining and treating the combined effects of parental drug use and interparental violence on children in their homes. Aggression and Violent Behavior, 25, 76–82. doi:10.1016/j.avb.2009.09.002.

    Article  Google Scholar 

  • Kelley, M. L., D’Lima, G. M., Henson, J. M., & Cotton, C. (2014). Substance-abusing mothers and fathers’ willingness to allow their children to receive mental health treatment. Journal of Substance Abuse Treatment, 47, 106–111. doi:10.1016/j.jsat.2014.02.007.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kelley, M. L., Bravo, A. J., Braitman, A. L., Lawless, A. K., & Lawrence, H. R. (2016). Behavioral couples treatment for substance use disorder: Secondary effects on the reduction of risk for child abuse. Journal of Substance Abuse Treatment, 62, 10–19. doi:10.1016/j.jsat.2015.11.008.

    Article  Google Scholar 

  • Kelly, S., Epstein, E. E., & McCrady, B. S. (2004). Pretreatment attrition from couple therapy for male drug abusers. The American Journal of Drug and Alcohol Abuse, 30, 1–19. doi:10.1081/ADA-120029861.

    Article  PubMed  Google Scholar 

  • Klostermann, K., Kelley, M. L., Mignone, T., Pusateri, L., & Wills, K. (2011). Behavioral couples therapy for substance abusers: Where do we go from here? Substance Use & Misuse, 46, 1502–1509. doi:10.3109/10826084.2011.576447.

    Article  Google Scholar 

  • Kovacs, M. (1992). Children’s Depression Inventory (CDI): Technical manual update. North Tonawanda: Multi-Health Systems Inc..

    Google Scholar 

  • Kownacki, R. J., & Shadish, W. R. (1999). Does alcoholics anonymous work? The results from a meta-analysis of controlled experiments. Substance Use & Misuse, 34, 1897–1916. doi:10.3109/10826089909039431.

    Article  Google Scholar 

  • Lester, B. M., Andreozzi, L., & Appiah, L. (2004). Substance use during pregnancy: time for policy to catch up with research. Harm Reduction. Journal, 1, 5. doi:10.1186/1477-7517-1-5.

    Article  Google Scholar 

  • Lobbestael, J., Leurgans, M., & Arntz, A. (2011). Inter-rater reliability of the Structured Clinical Interview for DSM-IV Axis I disorders (SCID I) and Axis II disorders (SCID II). Clinical Psychology & Psychotherapy, 18, 75–79. doi:10.1002/cpp.693.

    Article  Google Scholar 

  • Luthar, S. S., Cushing, G., Merikangas, K. R., & Rounsaville, B. J. (1998). Multiple jeopardy: Risk and protective factors among addicted mothers’ offspring. Development and Psychopathology, 11, 117–136.

    Article  Google Scholar 

  • McCrady, B. S., Epstein, E. E., Cook, S., Jensen, N., & Hildebrandt, T. (2009). A randomized trial of individual and couple behavioral alcohol treatment for women. Journal of Consulting and Clinical Psychology, 77, 243–256. doi:10.1037/a0014686.

    Article  PubMed  PubMed Central  Google Scholar 

  • Minuchin, P. (1985). Families and individual development: provocations from the field of family therapy. Child Development, 56, 289–302. doi:10.2307/1129720.

    Article  Google Scholar 

  • Muthén, L.K. and Muthén, B.O. (1998–2012). Mplus user’s guide. Seventh edition. Los Angeles: Muthén & Muthén.

  • O’Farrell, T. J., & Clements, K. (2012). Review of outcome research on marital and family therapy in treatment for alcoholism. Journal of Marital and Family Therapy, 38, 122–144. doi:10.1111/j.1752–0606.2011.00242.x.

    Article  PubMed  Google Scholar 

  • O’Farrell, T. J., & Fals-Stewart, W. (2006). Behavioral couples therapy for alcoholism and drug abuse. New York: Guilford Press.

    Google Scholar 

  • Reynolds, C. R., & Richmond, B. O. (1978). What I think and feel: A revised measure of children's manifest anxiety. Journal of Abnormal Child Psychology, 6, 271–280. doi:10.1007/BF00919131.

    Article  Google Scholar 

  • Schumm, J. A., & O’Farrell, T. J. (2013). Families and addiction. In P. M. Miller (Ed.), Principles of Addiction: Comprehensive Addictive Behaviors and Disorders, 1 (pp. 301–312). San Diego: Academic Press.

    Google Scholar 

  • Serec, M., Švab, I., Kolšek, M., Švab, V., Moesgen, D., & Klein, M. (2012). Health-related lifestyle, physical and mental health in children of alcoholic parents. Drug and Alcohol Review, 31, 861–870. doi:10.1111/j.1465–3362.2012.00424.x.

    Article  PubMed  Google Scholar 

  • Smith, T., Linnemeyer, R., Scalise, D., & Hamilton, J. (2013). Barriers to outpatient mental health treatment for children and adolescents: Parental perspectives. Journal of Family Psychotherapy, 24, 73–92. doi:10.1080/08975353.2013.792203.

    Article  Google Scholar 

  • Spanier, G. B. (1976). Measuring dyadic adjustment: new scales for assessing the quality of marriage and similar dyads. Journal of Marriage and the Family, 38, 15–28. doi:10.2307/350547.

    Article  Google Scholar 

  • Stover, C. S., Easton, C. J., & McMahon, T. J. (2013). Parenting of men with co-occurring intimate partner violence and substance abuse. Journal of Interpersonal Violence, 28, 2290–2314. doi:10.1177/0886260512475312.

    Article  PubMed  PubMed Central  Google Scholar 

  • Straus, M. A., Hamby, S. L., Boney-McCoy, S., & Sugarman, D. B. (1996). The revised conflict tactics scales (CTS2) development and preliminary psychometric data. Journal of Family Issues, 17, 283–316. doi:10.1177/019251396017003001.

    Article  Google Scholar 

  • VanDeMark, N. R., Russell, L. A., O’Keefe, M., Finkelstein, N., Noether, C. D., & Gampel, J. C. (2005). Children of mothers with histories of substance abuse, mental illness, and trauma. Journal of Community Psychology, 33, 445–459. doi:10.1002/jcop.20062.

    Article  Google Scholar 

  • Varela, R. E., & Biggs, B. K. (2006). Reliability and validity of the Revised Children’s Manifest Anxiety Scale (RCMAS) across samples of Mexican, Mexican American, and European American children: A preliminary investigation. Anxiety, Stress & Coping: An International Journal, 19, 67–80. doi:10.1080/10615800500499727.

    Article  Google Scholar 

  • Vu, C. T., & Christensen, A. (2003). Methodology of outcome studies in couple therapy: Analysis and recommendations. Poster presented at the annual meeting of the Western Psychological Association. Vancouver, British Columbia, Canada

  • Wilens, T. E., Biederman, J., Bredin, E., Hahesy, A. L., Abrantes, A., Neft, D., …Aencer, T. J. (2002). A family study of the high-risk children of opioid- and alcohol-dependent parents. The American Journal on Addictions, 11, 41–51. doi: 10.1080/10550490252801620

    Article  Google Scholar 

  • Zhao, X., Lynch Jr., J. G., & Chen, Q. (2010). Reconsidering Baron and Kenny: Myths and truths about mediation analysis. Journal of Consumer Research, 37, 197–206.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Michelle L. Kelley.

Ethics declarations

Funding

This study was funded by the National Institute of Drug Abuse (R01 DA024740).

Conflicts of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

The study was approved by the institutional review board at the participating institution. All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Parents gave written consent for themselves and their children; youth gave verbal assent.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kelley, M.L., Bravo, A.J. & Braitman, A.L. Behavioral Couples Treatment for Substance Use Disorder: Secondary Effects on the Reduction of Youth Internalizing Symptoms. J Abnorm Child Psychol 45, 731–741 (2017). https://doi.org/10.1007/s10802-016-0197-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10802-016-0197-x

Keywords

Navigation