Drug and Alcohol Rehab for Couples

Couples rehab is a treatment option when two intimate partners are struggling with addiction. It can be the case that both people share an addiction, each person has a different addiction, or one person has an addiction and the other does not. 
Evidence Based
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Couples drug rehab and/or alcohol rehab is a tool to help intimate partners achieve sobriety together. If two people are in a strong relationship but struggle with addiction, drug and alcohol rehab for couples helps them get clean and reinforces their intimate bond. 

Couples rehab is an option when: 

  • A couple shares an addiction
  • Each person has a different addiction
  • One person has an addiction and the other does not

How Addiction Affects Relationships

Research has shown that addiction affects relationships in different ways. It all depends on the nature of the relationship and the roles each person plays. For example, a child with a parent with an addiction is affected differently than a family member with a sibling or cousin with an addiction.

When a person with an addiction is someone’s partner, the effects most often tend to be psychological and economic. Partners are the first in line to experience mood swings, lack of engagement in the relationship, emotional neglect, and reduced interest in sexual intimacy. 

Partners may also be codependent or forced into covering for their loved one or supporting their habit despite knowing there is a problem.

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Types of Rehabs for Couples

There are different types of rehabilitation programs for couples. Some programs help people get sober together in the same treatment program. This is an option for committed partners with a healthy relationship aside from their addiction.

Both must have a desire to get sober, which is a vital part of success in any rehab program. This shared motivation in couples’ rehab is a key element to overcoming addiction and reaffirming a commitment to each other.

Inpatient vs Outpatient Treatment

There are both couples’ inpatient treatment and couples’ outpatient treatment options.

Inpatient options mean couples are living in a facility and wholly focused on recovery. Outpatient treatment programs offer treatment that fits into other responsibilities and obligations in life. For example, a couple in outpatient treatment could still work and care for other family members while also attending treatment sessions.

Both outpatient and inpatient treatment programs offer a variety of different types of treatment. 

For example:

Behavioral Couples Therapy (BCT)

Behavioral Couples Therapy (BCT) is a family-oriented approach to couples drug rehab. It’s an approach that is successful for couples living together and dealing with addiction. Couples find this type of therapy helps them improve their relationship, manage issues with enabling and codependency, and create a new dynamic that is healthy and sober.

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Behavioral Couples Therapy for Alcohol Use Disorders (ABCT)

Behavioral Couples Therapy for Alcohol Use Disorders (ABCT) is an outpatient treatment option. It helps those with an addiction to alcohol, as well as their intimate partners. The foundation of ABCT includes the following assumptions:

  • Interactions between couples can trigger alcohol abuse
  • Partners can reward abstinence
  • Positive intimate relationships are a key source of motivation for those abusing alcohol
  • Reducing distress in an intimate relationship reduces the risk of relapse

ABCT therapists work with both partners to identify and reduce the trigger behaviors of the non-abusing partner. 

Other goals of ABCT treatment include:

  • Strengthen the non-using partner’s ability to provide positive support via sobriety contracts
  • Increase positive interactions between the couple via assignments and suggested activities
  • Improve constructive communication and problem-solving
  • Improve coping skills and relapse prevention techniques

The goal of ABCT is to help an individual maintain abstinence with the support of an intimate partner and support both parties in a healthy relationship.

Recovering Couples Anonymous (RCA)

Recovering Couples Anonymous (RC) is a fellowship group of intimate partners committed to sober living. Members work to improve communication and intimacy in their relationships. Couples in the program come together to heal their relationships and learn to manage addiction with the support of their partners.

The philosophy of RCA is that relationships need constant nurturing and care from both partners. Both partners must accept mutual responsibility for the challenges in their relationship and recognize that individual development is essential for recovery and a healthy relationship.

RCA is not affiliated with Alcoholics Anonymous or any of the similar programs but it is based on the Twelve Steps. Members work the Twelve Steps together as a couple and experience healing as individuals and as a couple. The experience of using a 12 Step program in recovery together can be a powerful bonding experience for many couples.

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Dual Diagnosis Treatment

Estimates show that nearly 50 percent of people with an addiction also have a co-occurring disorder.

This makes it more difficult to overcome an addiction and in most cases, requires a person to receive dual diagnosis treatment. This means he or she will participate in a problem that offers support for both substance abuse and mental health issues, such as anxiety, depression, PTSD, and more.

Dual diagnosis treatment programs can be difficult to find. Addictions that occur with other disorders are complex to treat and require a significant amount of specialized knowledge.

Historically, addiction treatment and mental health treatment were separate systems of care. Though this is changing, there are still many treatment programs that operate this way. Finding the right treatment program when you are dealing with two or more disorders is a challenge. As medical professionals discover more and more people in need of dual diagnosis treatment, the dual diagnosis treatment approach will likely expand.

Recent studies have shown integrated treatment programs for people with co-occurring disorders are the most effective option. These programs combine addiction treatment and psychiatry. The results are positive and there is evidence integrated programs reduce the rate of relapse and suicide attempts.

Benefits of integrated treatment for those with dual diagnosis include:

  • Management and support for low motivation, social anxiety, ADD, and ADHD
  • Increased effectiveness of medication
  • Strong peer support network that includes other people with similar mental health issues
  • Ability to address unique relapse triggers, which include mood swings, panic attacks, and depression

Treatment length varies and what you should expect is based on your specific issues.

When Couples Treatment Isn’t Recommended

As effective as couples drug rehab might be, there are instances in which it would not be recommended. 

For example:

  • One partner has treatment needs requiring a special facility
  • One partner is diagnosed with an antisocial personality disorder
  • Ongoing domestic abuse is an issue in the relationship
  • Only one partner has a desire to enter rehab
  • One or both partners have no desire to continue the relationship after rehab
  • One partner needs to work through past trauma or abuse
  • One partner is forcing the other partner to go against their will
  • When the couple can't decide on the end goal of therapy

Choosing to enter treatment, with or without your partner, is a difficult choice. When both partners are ready to recover, couples’ drug rehab can be an effective tool and can help to strengthen a relationship long-term.

Resources

O’Farrell, T J, and W Fals-Stewart. “Behavioral Couples Therapy for Alcoholism and Drug Abuse.” Journal of Substance Abuse Treatment, vol. 18, no. 1, 2000, pp. 51–4, www.ncbi.nlm.nih.gov/pmc/articles/PMC3215582/

Epstein, Elizabeth E, and Barbara S McCrady. “Behavioral Couples Treatment of Alcohol and Drug Use Disorders: Current Status and Innovations.” Clinical Psychology Review, vol. 18, no. 6, 1 Sept. 1998, pp. 689–711, www.sciencedirect.com/science/article/abs/pii/S0272735898000257, 10.1016/S0272-7358(98)00025-7

“Recovering Couples Anonymous.” RCA, recovering-couples.org/

Center for Substance Abuse Treatment. “Substance Abuse Treatment and Family Therapy.” Nih.Gov, Substance Abuse and Mental Health Services Administration (US), 2014, www.ncbi.nlm.nih.gov/books/NBK64265/

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Updated on: June 24, 2020
Author
Addiction Group Staff
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Medically Reviewed
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Annamarie Coy,
BA, CADACII/ICADC, ICPR, MATS
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