title: Assessing the helping alliance and its impact in the treatment of opiate dependence.
abstract: 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.
authors.affiliation: Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia Veterans Affairs Medical Center 19104, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Belding
authors.forename: M Y
authors.initials: MY
authors.lastname: Iguchi
authors.forename: A R
authors.initials: AR
authors.lastname: Morral
authors.forename: A T
authors.initials: AT
authors.lastname: McLellan
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006379:Helping Behavior; D006556:Heroin Dependence / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D010343:Patient Admission; D011369:Professional-Patient Relations; D011613:Psychotherapy; D015813:Substance Abuse Detection; D014040:Token Economy; D016896:Treatment Outcome
chemical_list: D008691:Methadone