A nonblinded randomized trial was conducted at two Canadian provincial outpatient addiction clinics that tested the effectiveness of a systemic congruence couple therapy (CCT) versus individual-based treatment-as-usual (TAU) on nine clinical outcomes: (1) primary outcomes-alcohol use and gambling, psychiatric symptoms, and couple adjustment; (2) secondary outcomes-emotion regulation, substance use, depression, post-traumatic stress symptoms, and life stress. Data of primary clients and partners (N = 46) were analyzed longitudinally across baseline, posttreatment (5 months), and follow-up (8 months). Alcohol use disorder (95%) and gambling disorder (5%) were in the severe range at baseline, and co-addiction was 27%. Psychiatric comorbidity was 100%, and 18% of couples were jointly addicted. Between-group comparison favored CCT in primary outcomes with medium-to-large effect sizes (Cohen's h = 0.74-1.44). Secondary outcomes were also significantly stronger for CCT (Cohen's h = 0.27-1.53). Within-group, for all primary outcomes, a significant proportion of symptomatic CCT clients and partners improved, converging with ANOVA results of large effect sizes (0.14-0.29). All secondary outcomes improved significantly in CCT with large effect sizes (0.14-0.50). TAU showed significant within-group improvement in alcohol use, other substance use, and life stress with large effect sizes (0.16-0.40). Primary clients and partners made largely equivalent improvement within CCT and within TAU. Results were triangulated with clients' satisfaction ratings and counselors' reports. Overall, significant within-group effects were detected for CCT both clinically and statistically and between-group difference favored CCT. Future trials are required to validate these promising findings.
本研究对加拿大的两个省级门诊诊所进行了一项非盲法随机试验，测试了系统一致性伴侣疗法(CCT)与基于个体的常规治疗(TAU)在九个临床结果上的有效性: (1)主要结果--酒精使用和赌博、精神症状和伴侣适应; (2) 次要结果-- 情绪调节、药物使用、抑郁、创伤后应激障碍(PTSD)和生活压力。本研究对46例数据进行基线、治疗后(5个月)和随访(8个月)的纵向分析。酒精使用障碍(95%)和赌博障碍(5%)属于严重范围，共同成瘾为27%。精神疾病共病率为100%，共同成瘾夫妇为18%。在组内，有症状的CCT患者和伴侣在所有主要结果上都有改善(效应量= 0.07-0.26)，与大效应量的方差分析结果(效应量= 0.14-0.29) 趋同。所有次要结果在CCT中均有显著改善，且效应量较大(效应量= 0.14-0.50)。TAU在酒精使用、其他物质使用和生活压力方面有显著组内改善，效应量较大(效应量= 0.16-0.40)。在组间比较中，CCT对主要结果具有中到大的效应量(Cohen’s h效应量= 0.74-1.44)。CCT的次要结果也明显更强(Cohen h效应量= 0.27-1.53)。主要来访者和其伴侣与CCT进行了同等的改进。研究结果与来访者满意度评分和咨询师报告进行了三角分析。临床和统计学上均检测到CCT的显着组内效应，组间差异有利于CCT。需要未来的试验来验证这些有希望的发现。.
Keywords: alcohol use disorder; comorbidities; congruence couple therapy; couple adjustment; emotion regulation; gambling disorder; life stress; randomized controlled trial; systemic therapy; 伴侣调整; 合并症; 和谐夫妻治疗; 情绪调节; 赌博障碍; 酒精使用障碍.
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