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Full Text, Thesis (PhD Doctorate), Doctor of Philosophy (PhD), School of Applied Psychology, There is a strong association between alcohol and relationship problems, with each problem exacerbating the other. In this program of research two studies were conducted. The first study was to investigate the variables that put couples at risk for developing a combination of relationship and alcohol problems. The second study was an evaluation of the effects of an integrated education program that promoted safe drinking and positive relationship interaction. Previous research shows that deficits in negative affect regulation and poor communication predict the onset of both relationship and alcohol problems. Based on these findings, it was hypothesized that deficits in communication exist in couples in which one or both partners drink at hazardous levels. In Study 1 communication of 85 couples (53 couples with no high-risk drinker and 32 couples with at least one at-risk drinker) in early stage committed relationships was assessed by observation of their interaction. Couples in which the man was drinking at hazardous levels had significantly more negative communication than couples without an at-risk drinker. In Study 2, 37 couples with at least one at-risk drinker were randomly assigned to either Controlling Alcohol and Relationship Enhancement (CARE) or a control condition. Couple communication, alcohol consumption, relationship satisfaction and relationship stability were assessed at pre- and post-intervention. Alcohol consumption, relationship satisfaction and relationship stability were also assessed at 6-month follow-up. Couples receiving CARE improved their communication significantly relative to the control couples. Couples in both conditions showed significant reductions in hazardous drinking, but there was no significant difference in the effects of the interventions on alcohol consumption. The program of research demonstrates that deficits in couple communication are evident in couples with hazardous male drinking, even in the early stage of the relations

Aim: To evaluate the effectiveness of three approaches to assisting the female partners of male problem drinkers with the stress imposed by the male's drinking. Design: Participants were assigned randomly via random number tables to one of three treatment conditions: supportive counselling, stress management or alcohol‐focused couples therapy. Setting: The intervention took place at the Behaviour Research and Therapy Centre (BRTC), The University of Queensland. This research and training centre offers outpatient psychology services to the community. Participants: Sixty‐one married women whose husbands drank heavily. Participants reported protracted alcohol problems, severe impact of alcohol on social functioning and severe marital distress. Measurement: The women's stress, alcohol consumption by the male, and relationship functioning were assessed at pre‐ and post‐treatment and at 6‐month follow‐up. Interventions: All three treatments involved 15 1‐hour sessions with the woman. In the alcohol‐focused couple therapy, attempts were made to engage the man in these sessions. Results: Contrary to our predictions, there were few differences between the treatments. All three treatments were associated with reductions in the women's reported stress, with trends for somewhat greater reduction in the women's stress in the stress management and alcohol‐focused couples therapy conditions than for supportive counselling. None of the treatments produced clinically significant reductions in men's drinking or relationship distress. Conclusion: The treatments ease stresses and burden but do not improve drinking or relationships. Limited power in the design restricted the capacity to detect differential treatment effects.

This article is a review of the association of individual and marital problems. The focus is on depression, alcohol abuse, anxiety disorders, and the functional psychoses, each of which interact with marital distress in important ways. Although the causal connections between these disorders and marital distress are complex and only particularly understood, the available evidence shows that individuals’ and couples’ problems often exacerbate each other. Consequently, regardless of whether the initial presentation is individual or couple focused, there is routinely a need to assess both individual and relationship functioning. Couples therapy, and in particular behavioral couples therapy (BCT), is an important element of effective treatment of depression, alcohol abuse, anxiety disorders, and the functional psychoses. The integration of couple and individual therapy presents a number of clinical challenges, and in concluding this article the authors provide guidelines for managing these challenges.