Review of outcome research on marital and family therapy in treatment for alcoholism

This review of controlled studies of marital and family therapy (MFT) in alcoholism treatment updates the earlier review by O'Farrell and Fals-Stewart (2003). We conclude that, when the alcoholic is unwilling to seek help, MFT is effective in helping the family cope better and motivating alcoholics to enter treatment. Specifically, both Al-Anon facilitation and referral and spouse coping skills training (based on new findings) help family members cope better, and CRAFT promotes treatment entry and was successfully transported to a community clinic in a new study. Once the alcoholic enters treatment, MFT, particularly behavioral couples therapy (BCT), is clearly more effective than individual treatment at increasing abstinence and improving relationship functioning. New BCT studies showed efficacy with women alcoholics and with gay and lesbian alcoholics, and BCT was successfully transported to a community clinic, a brief BCT version was tested, and BCT was adapted for family members other than spouses. Future studies should evaluate the following: MFT with couples where both members have a current alcohol problem and with minority patients, mechanisms of change, transportability of evidence-based MFT approaches to clinical practice settings, and replication of MFT outcomes of reduced partner violence and improved child functioning.     

An Interaction Model of Business Service Production and Consumption

This paper develops a conceptual framework and model of the production and consumption of a business service. The model captures the interacting and dynamic nature of relationships between individuals both within and between client and supplier firms. The role played by the client during the different phases of production of the service will influence the degree to which the final service delivered meets the customer's specifications and the probability of implementation. Some empirical evidence of the complex interactions that occur in the creation of business services is presented and is used to suggest a modified typology of business services.     

A Convolution Estimator for the Density of Nonlinear Regression Observations

Abstract. The problem of estimating an unknown density function has been widely studied. In this article, we present a convolution estimator for the density of the responses in a nonlinear heterogenous regression model. The rate of convergence for the mean square error of the convolution estimator is of order n ^?1 under certain regularity conditions. This is faster than the rate for the kernel density method. We derive explicit expressions for the asymptotic variance and the bias of the new estimator, and further a data‐driven bandwidth selector is proposed. We conduct simulation experiments to check the finite sample properties, and the convolution estimator performs substantially better than the kernel density estimator for well‐behaved noise densities.     

MARITAL RELATIONSHIPS OF ALCOHOLIC,CONFLICTED, AND NONCONFLICTED COUPLES*

Twenty-six couples with alcoholic husbands, and 26 maritally conflicted and 26 nonconflicted couples without alcohol problems were compared. As predicted, the alcoholic and maritally conflicted couples did not differ, and both groups of problem couples showed greater relationship distress than nonconflicted couples on measures of marital stability, change desired, and positive communication behaviors. Contrary to predictions, alcoholic couples were not unique with respect to struggles for control, a pattern of wife dominance, a responsibility-avoiding style of communication by the alcoholic husband, or impaired perceptual accuracy. Unexpectedly, alcoholic husbands reported less marital unhappiness than both their wives and maritally conflicted husbands on most of the self-report marital satisfaction measures.     

A critical survey on the status of multiple criteria decision making theory and practice

This paper seeks to review and to contrast the main streams of thought in Multiple Criteria Decision Making (MCDM) theory and practice, without attempting to review all MCDM methods in detail. The main purpose is to identify pitfalls in the usage of various approaches, and to suggest approaches which are most robustly and effectively useable, especially by the non-expert in MCDM methodology. Problem areas in MCDM still requiring further research are also discussed.     

Alcohol abuse

We reviewed 38 controlled studies of marital and family therapy (MFT) in alcoholism treatment. We conclude that, when the alcoholic is unwilling to seek help, MFT is effective in helping the family cope better and motivating alcoholics to enter treatment. Specifically, (a) Al-Anon facilitation and referral help family members cope better; (b) Community Reinforcement and Family Training promotes treatment entry; and (c) the popular Johnson intervention apparently does not effectively promote treatment entry. Once the alcoholic enters treatment. MFT, particularly behavioral couples therapy (BCT), is clearly more effective than individual treatment at increasing abstinence and improving relationship functioning. BCT also reduces social costs, domestic violence, and emotional problems of the couple's children. Future studies need to specifically evaluate: MFT with women and with minority patients, mechanisms and processes of change, and transportability of evidence-based MFT approaches to clinical practice settings.