Couple-Based Treatment for Alcohol Use Disorders and Post-Traumatic Stress Disorder

Inclusion criteria

• Veteran must meet Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) criteria for current (past 12 months) alcohol abuse or dependence and alcohol must be the Veteran's primary substance of abuse as determined by a clinical algorithm (Fals-Stewart, Stappenbeck et al, 2004);
• Veteran must meet DSM-IV criteria for current (past month) PTSD;
• Veteran consumed alcohol in the past 90 days;
• couple must be married to or living with their current partner for at least 1 year;
• Veteran agrees to a goal of abstinence from drugs at least for the duration of the 15-week study-based treatment;
• Veteran agrees to the goal of abstaining from alcohol or consuming alcohol within low risk drinking guidelines during the duration of the 15-week study-based counseling;
• Veteran agrees to forego other treatment for alcohol-related disorders except for self help meetings (e.g., AA) or treatment required for a clinical emergency or clinical deterioration for the duration of the 15-week study based treatment;
• Veteran agrees to forgo other PTSD treatment except for treatment required for a clinical emergency or clinical deterioration for the duration of the 15-week study based treatment;
• couple agrees to forgo other couple-based counseling for the duration of the 15-week study based treatment except for treatment required for a clinical emergency or clinical deterioration;
• partner does not meet DSM-IV criteria for current (past 12 month) substance use disorder (other than nicotine)
• partner does not meet DSM-IV criteria for current (past month) PTSD.

Exclusion criteria

• Veteran has dependence on alcohol or other drugs that requires inpatient treatment or medical detoxification (as indicated by daily heavy use or use to prevent or deal with withdrawal symptoms) - after completing detoxification, Veteran may be eligible for the study;
• Veteran or partner are at immediate risk for suicide or homicide (current plan or intent);
• Veteran or partner exhibit a history of suicide or homicide attempt in the past year;
• Veteran is participating in a methadone maintenance or suboxone maintenance program and is seeking treatment for adjunctive outpatient services;
• Veteran or partner meets DSM-IV criteria for a current organic mental disorder, schizophrenia, delusional (paranoid) disorder, or any of the other psychotic disorders.