The Role of Therapeutic Alliance in Treatment for People with Mild to Moderate Alcohol Dependence
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In an exploratory study of Therapeutic Alliance (TA) in brief outpatient treatment for alcohol dependence the relationship was investigated between TA and treatment outcome (measured at 6 weeks and 6 months) for 69 alcohol dependent clients participating in a randomised control trial between Motivational Enhancement Therapy and Non Directive Reflective Listening. TA was significantly higher for clients who attended all four sessions. The correlation between TA and change in per cent days abstinent (PDA) between baseline and 6 weeks approached significance. TA was significantly correlated with the Alcohol Problem Questionnaire (APQ) at 6 months and with change in APQ scores between baseline and 6 months. These relationships remained significant when treatment assignment was controlled for. Whilst there was a trend towards a relationship between TA and change in PDA between baseline and 6 months, this trend no longer remained when both treatment assignment and early change in drinking levels were controlled for. Therapeutic alliance may be a useful additional maker to predict outcome, but early treatment response appears to be a better predictor.
KeywordsAlcohol dependence Therapeutic alliance Treatment outcome Engagement Treatment assignment
The authors would like to thank all clients who took part in the study. Thanks also to Professor Chris Frampton (University of Otago) for statistical advice. Funding was provided by the Health Research Council grant 96/328 and by the Alcohol Advisory Council of New Zealand. Ethical approval was granted by the Canterbury Regional Ethics Committee.
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