Center for Addiction Medicine, Massachusetts General Hospital, and Harvard Medical School, Boston, MA 02114, USA.
J Subst Abuse Treat. 2012 Oct;43(3):344-51. doi: 10.1016/j.jsat.2011.12.013. Epub 2012 Jan 28.
The therapeutic alliance is deemed to be integral to psychotherapeutic interventions, yet little is known about the nature of its role in treatment for substance use disorders (SUD), especially among young people. We investigated baseline predictors of the therapeutic alliance measured midtreatment and tested whether the alliance influenced during-treatment changes in key process variables (psychological distress, motivation, self-efficacy, coping skills, and commitment to Alcoholics Anonymous/Narcotics Anonymous [AA/NA]) independent of these baseline influences. Young adults in residential treatment (N = 303; age 18-24 years) were assessed at intake, midtreatment, and discharge. Older age and higher baseline levels of motivation, self-efficacy, coping skills, and commitment to AA/NA predicted a stronger alliance. Independent of these influences, participants who developed a stronger alliance achieved greater reductions in distress during treatment. Findings clarify a role for alliance in promoting during-treatment changes through reducing distress.
治疗联盟被认为是心理治疗干预的重要组成部分，但对于其在物质使用障碍（SUD）治疗中的作用，特别是在年轻人中的作用，知之甚少。我们研究了治疗联盟的基线预测因素，这些因素是在治疗中期测量的，并检验了联盟是否会影响治疗过程中的关键过程变量（心理困扰、动机、自我效能、应对技能和对匿名戒酒协会/匿名戒毒协会的承诺）的变化，而不受这些基线影响的影响。接受住院治疗的年轻人（N=303；年龄 18-24 岁）在入组时、治疗中期和出院时进行评估。年龄较大、基线动机、自我效能、应对技能和对匿名戒酒协会/匿名戒毒协会的承诺水平较高，预示着联盟更强。参与者与这些影响无关，他们发展出更强的联盟，在治疗过程中减轻了更多的痛苦。研究结果阐明了联盟在通过减轻痛苦来促进治疗期间变化方面的作用。
