title: Effect of shared decision-making on therapeutic alliance in addiction health care.
abstract: BACKGROUND
  In recent decades, shared decision-making (SDM) models have been developed to increase patient involvement in treatment decisions. The purpose of this study was to examine the effect of a shared decision-making intervention (SDMI) for substance-dependent patients on patients' and clinicians' perceptions of therapeutic alliance.
  
  
  METHODS
  Clinicians were randomly assigned to SDMI or usual procedures to reach a treatment agreement. SDMI is a structured, manualized, 5-session procedure to facilitate treatment agreement and consists of five standardized sessions.
  
  
  RESULTS
  Patients' perceptions of the therapeutic alliance were very favorable at start of treatment, and no differences were found between intervention groups. Clinicians' scores on perceived helpfulness and on the overall therapeutic alliance were higher in the SDMI group than in the controls, after 8 weeks of treatment and at the end of treatment.
  
  
  CONCLUSIONS
  The present study has shown that a specific intervention to enhance shared decision-making results in favorable changes in clinicians' perceptions of the therapeutic alliance.
authors.affiliation: Novadic-Kentron, Network for Addiction Treatment Services, Vught, the Netherlands;
authors.forename: Eag
authors.initials: E
authors.lastname: Joosten
authors.forename: Gh
authors.initials: G
authors.lastname: de Weert
authors.forename: T
authors.initials: T
authors.lastname: Sensky
authors.forename: Cpf
authors.initials: C
authors.lastname: van der Staak
authors.forename: Caj
authors.initials: C
authors.lastname: de Jong