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The role of the therapeutic allance in the treatment of alcoholic famlies Olson, Gregory Scott

Abstract

This study was part of a larger one called The Alcohol Recovery Project. The overarching aim of the present investigation was to broaden understanding regarding the role of the therapeutic alliance in the treatment of alcoholics within a systemic perspective. Using Pinsof and Catherall’s (1986) conceptualization of the affiance, a process-outcome study was conducted within both individual and conjoint formats. A sample of 63 alcoholic men and 21 non-alcoholic female partners was divided into three different treatment groups, two for individuals and one for couples. Several aspects of the affiance were investigated including: (a) the strength of the alliance in different treatments; (b) the impact of drinking behavior on the alliance; (c) the differential power of the affiance in predicting outcome in the individual therapeutic format compared to the conjoint one; (d) the impact of gender on alliance strength; and (e) the relationship between split amd intact affiances and therapeutic improvement. Results of the study indicated: (a) that the strength of the affiance was nearly identical in two very different therapeutic approaches; (b) that binge and chronic alcohol-use patterns served as potent predictors of the correlation between alliance and dyadic adjustment gain; (c) that the strength of the relationship between the affiance and therapeutic gain was not significantly different in individual as opposed to conjoint treatment (recognizing limitations in using the scales to compare modalities); (d) that women formed significantly stronger affiances than men; and (e) that the theoretical constructs of split and intact alliances could be empirically identified. The complexities inherent in interpreting results surrounding a process variable like the affiance became very evident as did the need for more study of the construct. Implications of the results were discussed, and recommendations made for future directions of research.

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