Background: Social network support for abstinence has been associated with improved treatment outcomes among samples of individuals with alcohol use disorders. As a result, research studies have focused on the inclusion of significant others (SOs) in the treatment process. Nonetheless, little is known about 1) the specific influence SOs may have on clients during treatment sessions or 2) whether SO within-session behaviors have any relationship to client post-treatment drinking. Method: In the current study, Motivational Enhancement Therapy sessions in which a SO was present were coded using a behavioral coding system designed to measure SO and client within-session language. Results: Relationships were observed between SO and client within-session language. Furthermore, some specific SO categories of language predicted post-treatment client drinking. Conclusions: This study is the first systematic evaluation of SO contributions in substance abuse treatment sessions. Future research examining SO language in the treatment of alcohol use disorders might allow clinicians to avoid contributions from SOs that are associated with poorer drinking outcomes.

Background: Common factors are important for the therapy outcome and also mediate the specific factors of therapy. As one of the common factors, client's expectations towards treatment have been understudied. Aims: The aim was to examine the pre-treatment expectations of outpatient substance abuse treatment clients (N = 327, 111 females, 216 males) and its impact on retention, effectiveness and satisfaction at 6-month follow-up. Method: Dependent variables included the clients’ attitudes towards the twelve-step principles and participation, medical treatment and therapists’ role. Results: An emphasis on the importance of medical treatment at baseline predicted dropping out. Similarly, it predicted a lower percent days abstinent (PDA6) at 6 months follow-up in comparison to those who did not consider medical treatment important for recovery. Percent days abstinent increased with a more positive attitude to mutual support. At follow-up, those who had assessed the therapist's role in recovery to be most important at the baseline were most satisfied with the treatment. Conclusions: The client's pre-treatment expectations have an impact on treatment retention and effectiveness. Further effort should be made to study how clients’ image of treatment could be improved and also how the commitment of the clients with multiple problems could be improved.

This study documents how residents experience Multiple Family Group (MFG) treatment in an 18-week residential therapeutic program for people with a severe substance disorder. Individual in-depth interviews with nine residents and three ex-residents of European descent were undertaken, and analysed using a descriptive thematic analysis. Results indicate that, prior to taking part in the program, their relationships with their families were seriously damaged and their situations often appeared complex and hopeless. After attending the MFGs all of the participants of this study experienced a number of positive changes in their relationships with their family members and partners. All interviewees said that they had gained more awareness about their interactions, better communications skills and were able to integrate these skills into their relationships with their families and partners.

In the last decade there has been increasing interest in working systemically with groups of families. Multiple family groups (MFGs) have been used in mental health settings with schizophrenia, eating disorders and drug and substance abuse. This article describes the MFG program used in Higher Ground Alcohol and Drug Rehabilitation Trust, a rehabilitation centre in Auckland, (New Zealand). Higher Ground provides an 18-week residential therapeutic program for people with a severe substance abuse disorder. The MFG in Higher Ground focuses on developing better communication patterns and better boundaries between family members, fostering mutual support, and promoting self-responsibility.