Predicting working alliance of substance-abusing clients and counselors

Abstract

Research suggests that client characteristics are important in the formation and continuance of the working alliance during treatment. However, research describing those characteristics is limited, especially in the field of substance abuse treatment. The present study examined the impact of pretreatment, client characteristics on the working alliance, which was rated by both clients and their counselors. Clients included 323 heroin users in methadone outpatient treatment. Of special interest were clients' levels of psychosocial functioning and social relations. Findings suggest that several client characteristics were associated with the quality of the alliance, that these measures differed depending on whose rating of the alliance was considered, and that several measures could distinguish among groups formed from combined counselor-client ratings of the alliance. A limited replication was attempted with a sample of women admitted to residential treatment. Most of the women were crack and/or alcohol addicted. Results for this sample showed some interesting differences.