Despite the abundance of rigorously conducted studies and findings supporting the efficacy of dyadic AUD treatment, evidence-based couple and family therapies are rarely applied in frontline treatment settings. Literature identifying barriers to provider uptake and patient utilization is also limited. The scant data available suggest that a lack of familiarity with modalities such as BCT among treatment providers and administrators of treatment clinics are among the most commonly cited challenges.100 Additional challenges include (a) logistical and time-related barriers to scheduling sessions with both members of a couple; (b) a lack of clarity regarding insurance reimbursements available for couple therapies (and whether reimbursements are greater than for individual sessions); (c) lack of formal training in couples therapies for AUD; and (d) perceived increase in the difficulty of implementing dyadic treatment compared to treating individuals with AUD.100 As a result, dissemination and implementation efforts are needed to identify more clearly provider and administrative barriers to uptake across various treatment settings (e.g., community clinics, Veterans Affairs clinics, academically affiliated clinics), to develop accessible provider education models, and ultimately to develop a more robust and diverse pipeline of capable and confident providers.
