O'Farrell T J, Fals-Stewart W
Harvard Families and Addiction Program, Harvard Medical School Department of Psychiatry, Veterans Affairs Medical Center, Brockton, Massachusetts 02301, USA.
Recent Dev Alcohol. 2001;15:329-56. doi: 10.1007/978-0-306-47193-3_19.
We reviewed 36 randomized studies of family-involved treatment and comparison conditions. A meta-analysis showed a medium effect size favoring family-involved treatments, over individual treatment or wait-list, for outcomes of alcohol use, treatment entry/attendance, and family adjustment. Studies of family-involved treatment when the alcoholic is unwilling to seek help show: (1) Al-Anon facilitation and referral help family members cope better; (2) the popular Johnson intervention apparently does not effectively promote treatment entry; and (3) Community Reinforcement and Family Training promotes treatment entry and should be disseminated if replicated. Studies of family-involved treatment to aid recovery when the alcoholic has sought help show: (1) evidence supporting behavioral couples therapy (BCT) has grown considerably; (2) the disulfiram contract procedure should be disseminated as part of a BCT treatment package; and (3) studies of family systems and of family disease approaches are beginning to appear in the literature. Future studies need to include more women and minority patients and focus on children.
我们回顾了36项关于家庭参与治疗及对照条件的随机研究。一项荟萃分析显示，对于酒精使用、治疗参与/出勤及家庭适应等结果，与个体治疗或等待名单相比，家庭参与治疗有中等效应量优势。对酗酒者不愿寻求帮助时的家庭参与治疗研究表明：（1）戒酒者互诫协会的促进和转诊帮助家庭成员更好地应对；（2）流行的约翰逊干预显然不能有效促进治疗参与；（3）社区强化与家庭训练促进治疗参与，若能重复验证则应推广。对酗酒者寻求帮助时促进康复的家庭参与治疗研究表明：（1）支持行为夫妻治疗（BCT）的证据大幅增加；（2）双硫仑合约程序应作为BCT治疗方案的一部分推广；（3）家庭系统和家庭疾病疗法的研究开始出现在文献中。未来研究需要纳入更多女性和少数族裔患者，并关注儿童。
