Pressures to Change Procedure


Engage family members in behavior strategies that are helpful in encouraging an individual to abstain from or reduce their problem drinking.

Pressure to changeStrategy

The Pressures to Change (PTC) procedure developed by Barber (1995; Barber & Crisp, 1995) begins with assessment and feedback and then focuses on teaching partners to encourage incompatible activities, avoid enabling, and negotiate contracts with the drinker to abstain or reduce drinking. The partner then enlists other individuals’ cooperation in applying these skills.

Target Population

Family members of persons with substance abuse problems

Research Outcomes

Three controlled trials have generally shown similar results. For example in the first trial (Barber & Crisp, 1995), there was a treatment entry rate of 44% under PTC conditions compared to 0% in the control condition. Approximately two-thirds of drinkers are reported to improve (enter treatment or stop drinking) following their partners’ participation in the PTC (Barber & Crisp, 1995; Barber & Gilbertson, 1996). This treatment was also examined in individual, group and self-help formats (Barber & Gilbertson, 1996, 1998) with similar results.

Outcomes Research References

Barber, J.G., & Gilbertson, R. (1996). An experimental study on brief unilateral intervention for the partners of heavy drinkers. Research on social work practice, 6(2), 325-336.

Barber, J.G. & Gilbertson, R. (1998). Evaluation of a self-help manual for the female partners of heavy drinkers. Research on Social Work Practice. 8(2), 141-151.

Clinical Approaches References

Barber, J.G. (1995). Working with resistant drug abusers. Social Work, 40(1), 17-23.

Barber, J.G., & Crisp, B.R. (1995). The 'pressures to change' approach to working with the partners of heavy drinkers. Addiction, 90, 269-276.