Development of working alliance was examined for 25 opioid-abusing pain patients and their therapists. Patients participated in an 8-session intervention based on adherence strategies and employing a supportive, psychoeducational approach; methadone was prescribed for pain. Treatment goals included opioid analgesic adherence and decreasing pain, functional interference, and substance abuse. Patients and therapists completed the Helping Alliance Questionnaire-II following each treatment session. At baseline, patients' and therapists' scores indicated good alliance. Patient alliance grew significantly over time, regardless of addiction severity and independent of treatment outcomes. In contrast, therapist alliance grew only for patients without substance abuse co-morbidity and/or who had good outcomes. Patients' and therapists' alliance scores were consistent during sessions focused on emotional bonds but diverged during sessions that demanded behavior change, suggesting therapists may have reacted negatively to patients' lack of progress. Whether therapists' reactions to poor performers impacted subsequent patient outcomes is unknown, but should be investigated.

Professional counselors and counseling psychologists have much to offer in treating substance use disorders (SUDs). Yet, research consistently demonstrates that students are not receiving adequate training in SUDs. This study describes the current state of training counseling and counseling psychology students in SUDs. Results are consistent with previous studies. Implications for training and practice are provided.

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Qualitative research studies are underrepresented in psychology journals, and those that are published vary in quality. As such, researchers have called for an improvement in the quantity and quality of qualitative research. This article represents an attempt to guide researchers wishing to conduct culturally competent qualitative research with people of African descent. To do so, the authors review potential areas of confluence between qualitative research and African cultural values (e.g., holism, emphasis on relationships). The authors also review and highlight best practices throughout the qualitative research process (e.g., topic selection, research team development, data analysis) that may facilitate a sense of safety for people of African descent as well as holistically and usefully represent their experiences.