Assessing the Helping Alliance and Its Impact in the Treatment of Opiate Dependence

Published in: Drug and Alcohol Dependence, v. 48, no. 1, Oct. 1997, p. 51-59

Posted on RAND.org on December 31, 1996

by Mark A. Belding, Martin Y. Iguchi, Andrew R. Morral, A. Thomas McLellan

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This study assesses the relationship between the patient-counselor helping alliance (HA) and progress in methadone maintenance treatment. Questionnaire measures of HA were administered to 57 patients 1 and 3 months after admission. Three-month HA measures (especially counselors' ratings) predicted reductions in drug use as measured by weekly urinalysis results and 6-month self-report data. HA was unrelated to treatment retention or improvement in psychiatric symptomatology. Moreover, controlling for urinalysis results in the previous month rendered insignificant the correlations between 3-month HA and subsequent drug use. Thus, this evaluation of the HA's unique contribution to the prediction of outcome suggests that the development of a positive HA may be more a marker of treatment progress than a necessary precursor of positive outcomes in the methadone maintenance treatment setting.

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