Journal of Substance Abuse Treatment
Volume 31, Issue 2 , Pages 157-162, September 2006

Therapeutic alliance and the relationship between motivation and treatment outcomes in patients with alcohol use disorder

  • Mark A. Ilgen, Ph.D.

      Affiliations

    • Corresponding Author InformationCorresponding author. Center for Health Care Evaluation, Department of Veterans Affairs Palo Alto Health Care System, 795 Willow Road (MPD 152), Menlo Park, CA 94025, USA. Tel.: +1 650 493 5000x27575.
    • ,
  • John McKellar, Ph.D.
    • ,
  • Rudolf Moos, Ph.D.
    • ,
  • John W. Finney, Ph.D.

Center for Health Care Evaluation, Department of Veterans Affairs Palo Alto Health Care System, Menlo Park, CA 94025, USA

Stanford University School of Medicine, Stanford, CA, USA

Received 12 December 2005; received in revised form 11 April 2006; accepted 17 April 2006. published online 14 July 2006.

Abstract 

Although motivational readiness to change predicts alcohol use disorder (AUD) treatment outcomes, little is known about treatment aspects that are helpful for patients with low motivation. We examined whether a positive therapeutic alliance is particularly beneficial for patients entering AUD treatment with low motivation. Among Project MATCH outpatients (n = 753), we tested the influence of motivation, therapeutic alliance, and their interaction on 6-month and 1-year alcohol use. The impact of motivation on alcohol use varied depending on therapists' perceptions of alliance. Interactions involving treatment compliance did not mediate the Motivation × Alliance interaction. Thus, a positive therapeutic relationship may be particularly important for patients with low motivation, but mechanisms underlying this possible patient–treatment “match” remain to be determined.

Keywords: Motivation, Alcohol use disorder, Therapeutic alliance, Treatment

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PII: S0740-5472(06)00103-6

doi:10.1016/j.jsat.2006.04.001

Journal of Substance Abuse Treatment
Volume 31, Issue 2 , Pages 157-162, September 2006

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