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Poster presented at the College on Problems of Drug Dependence (CPDD) annual meeting, San Juan, Puerto Rico, June 14-19, 2008.
Alyssa A. Forcehimes, PhD, Michael P. Bogenschutz, MD , J. Scott Tonigan, PhD (all from Center on Alcoholism, Substance Abuse and Addictions (CASAA), University of New Mexico, SW Node), George E. Woody, MD (University of Pennsylvania, DV Node).
Therapeutic alliance, representing the quality of the therapeutic relationship, has been correlated with positive treatment outcomes (Horvath & Symonds, 1991). This study, protocol CTN-0010 ("Buprenorphine/Naloxone-Facilitated Rehabilitation for Opioid Dependent Adolescents/Young Adults"), tested whether participants' perceptions of therapeutic alliance were associated with a reduction in opioid use. Adolescent and young adult opioid dependent patients were randomized to either as 12-week course of outpatient buprenorphine/naloxone plus psychosocial treatment or detox plus psychosocial treatment alone. All patients were offered weekly individual therapy sessions for the first three months of treatment.
The Helping Alliance Questionnaire (HAQ-II) was completed as part of the larger assessment battery administered at the 4-week follow up. The HAQ-II measures therapeutic alliance by rating 19 items on a scale of 1-6. Analyses were conducted to determine whether HAQ scores at 4 weeks were predictive of opioid use, defined as composite measures of weekly urine drug test (UA) screens across the 12 weeks of active treatment. A factor analysis was first conducted to determine the underlying structure of this instrument (alpha extraction and varimax rotation). One factor emerged with an eigenvalue >1, suggesting that the 19 items included in this instrument measured one construct. In general, scores were high on participants' perceptions of therapeutic alliance with their individual counselor. Across items and treatment conditions, participants (N=98) indicated a strong, positive relationship with their therapist, with mean scores = 96.80 + 14.83. Analyses were conducted to determine whether total HAQ-II scores differed by treatment condition. Findings indicated that the experimental group reported significantly higher alliance compared to the treatment-as-usual group (P=.007). However, the association between higher therapeutic alliance and lower rates of positive UA screens for opioids was not significant (r=.16; p=.11). Reasons why enhanced therapeutic alliance did not influence opioid use are discussed. (Poster, PDF, English, 2008)
 Keywords: Adolescents | Buprenorphine/Naloxone | Helping Alliance Questionnaire | Opioid dependence | Pharmacological therapy | Suboxone | Therapeutic alliance | Young adults | College on Problems of Drug Dependence (CPDD) annual meeting, 2008
Document No: 298
Approved by Alyssa Forcehimes, PhD, Node Coordinator, SW Node, (9/3/2008). |
