The Role of Therapeutic Alliance in Treatment for People with Mild to Moderate Alcohol Dependence

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.