Clinical Case Studies

 

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Clinical Case Studies, Vol. 3, No. 3, 187-205 (2004)
DOI: 10.1177/1534650103259633

Behavioral Couple Therapy in the Treatment of a Female Alcohol-Dependent Patient With Comorbid Depression, Anxiety, and Personality Disorders

Ellen Vedel

University of Amsterdame.vedel{at}uva.nl

Paul M. G. Emmelkamp

University of Amsterdam

Behavioral Couple Therapy (BCT) has shown to be effective in the treatment of alcohol dependence. However, it is still unclear whether this intervention is effective in severe caseswith comorbid other conditions. The aim of the present study is to illustrate the assessment, case conceptualization, prioritizing of interventions and treatment in a female "treatment resistant" alcohol-dependent patient, with comorbid depression, anxiety, personality disorders, andmarital problems, using a BCT manual. In total, the treatment consisted of 19 sessions, during a 7-month period. Results show BCT to be successful in treating alcohol dependence and to some extent increasing marital satisfaction. At posttreatment the patient did no longer meet criteria for major depressive disorder. At 3-month follow-up she had been abstinent for 51/2 months, with a 2-day lapse, and her depressive disorder was still in full remission. This case demonstrates—even with severe comorbid conditions—that targeting the drinking problem is the treatment of choice. However, we stress the importance of a thorough assessment of other Axis I and II disorders.

Key Words: behavioral couple therapy • alcohol dependence • comorbidity


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