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Journal of Consulting and Clinical Psychology
2009;77(6):1125–1135. [doi: 10.1037/a0017045]
Paul Crits-Christoph,
PhD (University of Pennsylvania School of Medicine, DV
Node), Robert Gallop (West
Chester University, DV Node), Christine
M. Temes (University of Pennsylvania School of Medicine,
DV Node), George E. Woody, MD
(University of Pennsylvania School of Medicine, DV Node), Samuel
A. Ball, PhD (Yale Community School of Medicine, NE Node),
Steve Martino, PhD (Connecticut
VA Healthcare Center, Yale University, NE Node), Kathleen
M. Carroll, PhD (Connecticut VA Healthcare Center, Yale
University, NE Node).
This ancillary investigation of data from protocol CTN-0004, a community-based multicenter
study of motivational enhancement therapy (MET) and counseling
as usual (CAU) for outpatient substance users, examines
questions about the role of the alliance in MET and CAU. Most (94%) of the
sample met diagnostic criteria for abuse or dependence (primarily
alcohol and/or cocaine). Sixteen therapists for CAU and 14 for
MET participated. No reliable differences in patient ratings (n=319)
on the Helping Alliance Questionnaire–II (HAq-II) were evident
for MET compared to CAU, but significant differences between therapists
were found within each condition in mean patient-rated HAq-II
scores. Overall, average levels of alliance were high. The between-therapists
component of the alliance, but not the within-therapist component,
was significantly associated with self-reported days of primary
substance use during the follow-up period from Week 4 to Week
16 (Cohen’s I=0 .39; n=257). Therapists with either low or
very high alliances had relatively poorer average outcomes (quadratic
effect, d=0.44). For therapists in both MET and CAU, increased
use of MET fundamental techniques and MET advanced techniques
during treatment sessions was associated with higher levels of
alliance. Implications of the findings for conceptualization of
the alliance and for training of therapists are discussed.
(Article (Peer-Reviewed), PDF, English, 2009)
Keywords: Behavior
therapy | Counselors | CTN
platform/ancillary study |
Motivational Enhancement Therapy (MET) | Helping
Alliance Questionnaire (HAQ-II) | Therapeutic alliance | Journal of Consulting and Clinical Psychology (journal)
Document No: 408, PMID: 19968388, PMCID: PMC2829757 (available 12/1/2010)
Submitted by CTN Dissemination Librarians,
12/29/2009.
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