Stanton M D, Shadish W R
Department of Psychiatry, University of Rochester Medical Center, USA.
Psychol Bull. 1997 Sep;122(2):170-91. doi: 10.1037/0033-2909.122.2.170.
This review synthesizes drug abuse outcome studies that included a family-couples therapy treatment condition. The meta-analytic evidence, across 1,571 cases involving an estimated 3,500 patients and family members, favors family therapy over (a) individual counseling or therapy, (b) peer group therapy, and (c) family psychoeducation. Family therapy is as effective for adults as for adolescents and appears to be a cost-effective adjunct to methadone maintenance. Because family therapy frequently had higher treatment retention rates than did nonfamily therapy modalities, it was modestly penalized in studies that excluded treatment dropouts from their analyses, as family therapy apparently had retained a higher proportion of poorer prognosis cases. Re-analysis, with dropouts regarded as failures, generally offset this artifact. Two statistical effect size measures to contend with attrition (dropout d and total attrition d) are offered for future researchers and policy makers.
本综述综合了包含家庭夫妻治疗条件的药物滥用结果研究。在涉及约3500名患者和家庭成员的1571个案例中，元分析证据表明，家庭治疗优于（a）个体咨询或治疗、（b）同伴群体治疗和（c）家庭心理教育。家庭治疗对成年人和青少年同样有效，并且似乎是美沙酮维持治疗的一种具有成本效益的辅助手段。由于家庭治疗的治疗保留率通常高于非家庭治疗方式，在那些将治疗退出者排除在分析之外的研究中，家庭治疗受到了一定程度的不利影响，因为家庭治疗显然保留了较高比例的预后较差的案例。将退出者视为失败进行重新分析，通常会抵消这种偏差。为未来的研究人员和政策制定者提供了两种应对损耗的统计效应量指标（退出损耗d和总损耗d）。
