Implementing Behavioral Couples Therapy for Substance Use Disorders in Real-World Clinical Practice.

Behavioral couple therapy (BCT) is an evidence-based, manualized treatment that has been primarily developed to treat alcohol use disorder. The treatment model leverages the intimate partner relationship to support recovery. Although the efficacy of BCT is well-supported in randomized controlled trials, little attention has been given to the translation of BCT to everyday practice settings. This article presents recommendations for implementing BCT in such settings. We describe a stepwise approach for getting a couple into BCT and determining whether it is an appropriate treatment for the couple. In addition, we provide recommendations for broadening inclusion criteria for everyday practice settings, including the use of BCT with couples who have drug use disorders with couples where both members exhibit substance use disorders and with couples who choose controlled drinking or drug use versus abstinence. Whereas BCT has mostly been researched in speciality substance use disorder settings, we provide recommendations for its use in general couple therapy settings. Based upon the extant research, we suggest implementing BCT as a standalone treatment or as an add-on to individual counseling for substance use disorders. We provide guidance for delivering BCT through telehealth and encourage future research to investigate this delivery modality. Future research should prioritize investigating the effectiveness of various BCT dissemination strategies and seek to determine what dosage and components of BCT will result in the best outcomes.