title: Therapeutic alliance and the relationship between motivation and treatment outcomes in patients with alcohol use disorder.
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 x 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.
authors.affiliation: Center for Health Care Evaluation, Department of Veterans Affairs Palo Alto Health Care System, Menlo Park, CA 94025, USA. mark.ilgen@med.va.gov
authors.forename: Mark A
authors.initials: MA
authors.lastname: Ilgen
authors.forename: John
authors.initials: J
authors.lastname: McKellar
authors.forename: Rudolf
authors.initials: R
authors.lastname: Moos
authors.forename: John W
authors.initials: JW
authors.lastname: Finney
mesh_terms: D000437:Alcoholism / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D006801:Humans; D009042:Motivation; D010348:Patient Care Team; D010349:Patient Compliance; D016896:Treatment Outcome