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We will modify our smartphone system A-CHESS (Addiction - Comprehensive Health Enhancement Support System) for relapse prevention for patients to create a system for couples with key components of Alcohol Behavioral Couples Therapy (ABCT).

The Need

Partner support can help prevent relapse because alcohol problems and intimate relationships are reciprocally related. Distress in the relationship, along with partner attempts to control patient substance use, may prompt craving and trigger relapse; alcohol use is associated with greater relationship conflict. Recovery destabilizes relationships. New patterns of interacting need to be negotiated to support each partner’s needs. Yet many partners do not know how to support recovery or manage their own responses to their partner’s changed behavior and symptoms of post-acute withdrawal, such as irritability. While partners can help prevent patient relapse, doing so may increase their own stress and negative affect. They may need help too. ABCT has demonstrated positive outcomes for men and women with alcohol use disorder (AUD). Recognizing the reciprocity between intimate relationships and alcohol problems, ABCT tries to build abstinence support and strengthen the couple relationship. ABCT uses the relationship to reward abstinence and teaches tools for better communication and more positive activities.

Despite its outcomes, ABCT has not been widely adopted because of complexity, stigma, and cost. Such technology, used in a smartphone, may be able to solve many access and cost issues, in part because of the pervasiveness of smartphones across all socioeconomic backgrounds. Smartphones are very portable, and smartphone software can be modified quickly in response to newly identified needs. Compared with existing counseling programs, mobile applications have the potential to provide services to more people, more often, for a longer period of time, with greater reach to a patient’s social support systems. Furthermore, being able to receive help without attending 12-step meetings and sessions at the clinic can reduce stigma.


A total of 40 dyads will be recruited to the study from SSTAR (a large addiction treatment agency in Massachusetts). Each dyad will have one person diagnosed with AUD. Six dyads will test iterative prototypes of the new PartnerCHESS. We propose to:

  • develop the PartnerCHESS technology (a combination of A-CHESS and ABCT features)
  • pilot test the technology and the protocol, procedures, recruitment, data collection, analytical strategies, and operations to be used in a large randomized clinical trial (RCT)
  • use the information and insights gathered from the pilot test to finalize plans for a large-scale RCT

Partners / Participant Sites

  • SSTAR Addiction Treatment, Fall River, MA

Funding Period:
September 1, 2017 - February 29, 2020
Principal Investigators:
David Gustafson Sr., Ph.D
Elizabeth Epstein, Ph.D.
David Gustafson Jr.