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 × 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. [Copyright &y& Elsevier]