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Article
Publication date: 11 June 2018

Luís Janeiro, Eugénia Ribeiro, Luís Faísca and María José Lopez Miguel

A better therapeutic alliance at the beginning of treatment for addictive behaviours has been found to prevent dropout. The purpose of this paper is to evaluate how the…

Abstract

Purpose

A better therapeutic alliance at the beginning of treatment for addictive behaviours has been found to prevent dropout. The purpose of this paper is to evaluate how the development of therapeutic alliance dimensions was associated with the dropout prevention.

Design/methodology/approach

A total of 23 participants presented a substance use disorder related to heroin or cocaine and were in three distinct treatment phases of a therapeutic community. Each participant filled in the therapeutic alliance measures once a week after mini-groups. A naturalistic prospective research design was used to collate 198 repeated alliance measures.

Findings

Participants who presented stable bond development at higher levels tended to stay in treatment, whereas those who developed stable bonds at lower levels tended to drop out. The goals and tasks dimension increased significantly across the phases and was not associated with dropout.

Practical implications

To prevent dropout, therapists should pay special attention to residents who manifest difficulties in establishing stable and secure bonds and not overestimate the impact of the goals and tasks alliance dimension, as it is not a failsafe indicator of treatment retention.

Originality/value

The alliance dimensions were differentiated (bond, goals and tasks) and studied throughout the treatment, pointing out the importance of therapeutic relationship dynamic variables to prevent dropout.

Details

Therapeutic Communities: The International Journal of Therapeutic Communities, vol. 39 no. 2
Type: Research Article
ISSN: 0964-1866

Keywords

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Article
Publication date: 9 April 2021

Sofia Vicente, Laura Inês Ferreira, Antonia María Jiménez-Ros, Cláudia Carmo and Luís Janeiro

This study aims to investigate whether the influence of group cohesion on the outcomes depended on the levels of the therapeutic alliance.

Abstract

Purpose

This study aims to investigate whether the influence of group cohesion on the outcomes depended on the levels of the therapeutic alliance.

Design/methodology/approach

Sixteen individuals with a substance use disorder who were undergoing treatment in a therapeutic community responded to therapeutic alliance, group cohesion, craving and outcomes measures after every therapeutic small group session for a period of six weeks. Data analysis was performed using hierarchical linear modeling.

Findings

Results indicate that the effect of group cohesion is stronger when there is a high therapeutic alliance between resident and therapist.

Originality/value

Even on group interventions, to enhance group cohesion effects on outcomes, therapists must foster higher therapeutic alliance levels. The findings point out the importance of studying the effect of common factors on outcomes.

Details

Therapeutic Communities: The International Journal of Therapeutic Communities, vol. 42 no. 1
Type: Research Article
ISSN: 0964-1866

Keywords

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