Integrative Couple Treatment for Addiction: A revised model based on forgiveness and attachment needs

The workshop, centered on clinical implications, presents a) results from a qualitative study on participants’ experience in individual versus couple treatment , b) Results from a multiple single cases study about the role of forgiveness in the ICT and c) A clinical presentation of the adapted version of ICT-Addiction.

Decades of research illustrate the efficacy of behavioral cognitive couple therapy in addiction. Our previous studies, qualitative and quantitative, combined with our clinical experience, convinced us about the need to better address profound relationship wounds created by repeated lies and betrayals provoked by addiction. Forgiveness processes and attachment theory guided our update efforts of the ICT. A task force, composed of the original developers of the ICT, experienced clinicians in addiction couple therapy, an expert in forgiveness processes, and an international expert in Emotionally focused couple therapy (EFT), developed and adapted version of the ICT where clinicians better address the need to repair relationship wounds.

In the new version of ICT (version 2.0), the work on communication processes is now strongly oriented toward the identification of the unadapted interaction cycle where couples exchanges are based on secondary emotions (mainly reproaches toward the partner) rather than primary ones (attachment fears). After the identification of this cycle, the goal is to reconnect partners to work together, a) against their ineffective ways of communicating about addiction and b) against addiction itself. A strong accent is put on attachment needs and repair processes.

Otherwise, we keep the same structure of treatment with the first part of a session centered on addiction behaviors and the second on couple’s topics. ICT still accentuate the necessity to improve reinforcers of abstinence/reduction and to reduce reinforcers of addiction, while improving multiple small positive reinforcers of the relationship. We will present the clinical version of the revised ICT-Addiction.