Review of Outcome Research on Marital and Family Therapy in Treatment for Alcoholism


  • Timothy J. O’Farrell, PhD, is Professor of Psychology, and Kahni Clements, PhD, is Instructor in Psychology, Harvard Medical School Department of Psychiatry, VA Boston Healthcare System.

  • Preparation of this article was supported by a grant to the first author from the National Institute on Alcohol Abuse and Alcoholism (R01AA017865) and by the Department of Veterans Affairs.

Address correspondence to Timothy J. O’Farrell, VAMC-116B1, 940 Belmont St., Brockton, Massachusetts 02301; E-mail:


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.