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