Couples therapy interventions can be used with alcohol abusers and alcoholics during three broadly defined states of recovery: (1) initial commitment to change; (2) change itself; and (3) long-term maintenance of change. Intervening with the alcoholic's spouse (and/or other nonalcoholic family members) can motivate and reinforce commitment to change in the alcoholic who is unwilling to seek help or reluctant to continue in treatment. Simple and inexpensive methods of intervening with the spouse and family have increased continuing treatment participation by alcoholics. In a 2-week residential detoxification program, the continuation rate increased by 57 percent in the 2 years after the introduction of a family program that involved routinely meeting with a spouse and establishing a contract specifying contingencies regarding further treatment. Couples or spouse-involved therapy, either alone or in addition to individual treatment for the alcoholic, produces better outcomes during the year after treatment entry than individual methods. Recent well-controlled studies have focused on behavioral marital therapy (BMT). Currently a very promising couples therapy approach is BMT that combines both a focus on the drinking plus work on more general marital relationship issues. However, the BMT outcomes and their degree of superiority over individual treatment have been shown to fade over time, suggesting a need for treatment and research designed to specifically enhance maintenance after BMT alcoholism treatment. (23 references) (LLL)