Dennis Cory B, Roland Brian D, Loneck Barry M
a School of Social Work, Brigham Young University , Provo , UT , USA.
b Department of Behavioral Sciences , Indiana Wesleyan University , Marion , IN , USA.
Am J Drug Alcohol Abuse. 2018;44(3):378-385. doi: 10.1080/00952990.2017.1378892. Epub 2017 Oct 19.
The working alliance plays an important role in the substance use disorder treatment process. Many substance use disorder treatment providers incorporate the 12-Step approach to recovery into treatment. With the 12-Step approach known among many clients and clinicians, it may well factor into the therapeutic relationship.
We investigated how, from the perspective of clients, a clinician's level of familiarity with and in-session time spent on the 12-Step approach might affect the working alliance between clients and clinicians, including possible differences based on a clinician's recovery status.
We conducted a secondary study using data from 180 clients and 31 clinicians. Approximately 81% of client participants were male, and approximately 65% of clinician participants were female. We analyzed data with Stata using a population-averaged model.
From the perspective of clients with a substance use disorder, clinicians' familiarity with the 12-Step approach has a positive relationship with the working alliance. The client-estimated amount of in-session time spent on the 12-Step approach did not have a statistically significant effect on ratings of the working alliance. A clinician's recovery status did not moderate the relationship between 12-Step familiarity and the working alliance.
These results suggest that clinicians can influence, in part, how their clients perceive the working alliance by being familiar with the 12-Step approach. This might be particularly salient for clinicians who provide substance use disorder treatment at agencies that incorporate, on some level, the 12-Step approach to recovery.
工作联盟在物质使用障碍治疗过程中发挥着重要作用。许多物质使用障碍治疗提供者将12步康复法纳入治疗。鉴于许多客户和临床医生都了解12步康复法，它很可能会影响治疗关系。
我们从客户的角度调查了临床医生对12步康复法的熟悉程度以及在治疗过程中花费在该方法上的时间如何影响客户与临床医生之间的工作联盟，包括基于临床医生康复状态的可能差异。
我们使用来自180名客户和31名临床医生的数据进行了一项二次研究。大约81%的客户参与者为男性，大约65%的临床医生参与者为女性。我们使用总体平均模型在Stata中分析数据。
从患有物质使用障碍的客户的角度来看，临床医生对12步康复法的熟悉程度与工作联盟呈正相关。客户估计的在治疗过程中花费在12步康复法上的时间对工作联盟评分没有统计学上的显著影响。临床医生的康复状态并没有调节12步康复法熟悉程度与工作联盟之间的关系。
这些结果表明，临床医生通过熟悉12步康复法，在一定程度上可以影响客户对工作联盟的看法。对于在某种程度上采用12步康复法的机构中提供物质使用障碍治疗的临床医生来说，这可能尤为重要。
