The substance abuse field has been slow to embrace research into the impact of the therapeutic relationship on treatment outcome. Limited previous research has demonstrated that therapist factors such as unconditional regard and empathy are associated strongly with treatment outcome. This study examined the relationships between client perception of the therapist and client characteristics; client response to out-patient relapse prevention treatment; and client outcome 3 months following treatment for alcohol dependence. One hundred and sixty-one male clients of a 3-week relapse prevention programme participated in the research, completing questionnaires assessing their perception of therapist regard, empathy, congruence, attractiveness, expertness and trustworthiness. Treatment outcome was measured at the conclusion of treatment, and 3 months post-treatment. Clients who were more anxious and those with poorer cognitive functioning appeared to perceive therapists as showing less unconditional regard, empathy and congruence. Self-efficacy and coping skills acquisition measured at the end of treatment correlated significantly with clients' perceptions of the therapist as empathic, congruent and displaying high regard for them. Treatment outcome at 3 months was associated significantly with degree of perceived therapist expertness and empathy. These relationships held when cognitive functioning and skills acquisition were controlled for. Self-efficacy moderated the relationships between regard and empathy and outcome, but not perceived therapist expertness. A lower than desirable follow-up rate limits the generalizability of the findings. The quality of the therapeutic relationship as perceived by clients appears to be associated with client characteristics, response to treatment and treatment outcome.
This study examined the joint factor structure of the WAIS-R and WMS-R in a sample of 289 participants (mostly males) with alcohol dependency. In a confirmatory phase we contrasted a range of factor models derived from previous analyses of the Wechsler scales. The best fitting model incorporated five factors representing Verbal Comprehension, Perceptual Organization, Attention-Concentration, Verbal Memory, and Visual Memory, with reassignment of factor loadings for two subtests. The invariance of the measurement model was then examined comparing data from a large sample of healthy participants (J. R. Carstairs & E. A. Shores, 1999). The results indicated that the number of factors was invariant across samples, and four of the factors satisfied the criterion of partial measurement invariance.
A Severity of Amphetamine Dependence Questionnaire (SAmDQ) was administered to 101 subjects attending an Australian drug dependency treatment centre. The SAmDQ was adapted from the Severity of Opiate and Alcohol Dependence Questionnaires (SODQ & SADQ). The structural characteristics of the SAmDQ were examined and compared with previous findings reported on samples of opiate addicts with the SODQ. A high degree of consistency was found between the results obtained with the SAmDQ and previous findings with the SODQ. The relationship between the SAmDQ and the Severity of Dependence Scale (SDS) was also examined. The findings suggest that further development of amphetamine dependence measurement is required.
The Severity of Opiate Dependence Questionnaire (SODQ) was administered to 114 subjects attending an Australian drug dependency treatment centre. The psychometric properties of the SODQ were examined and compared with previous findings reported on American and British samples of opiate addicts. Severity of opiate dependence was assessed independently using a structured clinical interview based on DSM-III-R criteria (i.e. SCID-R). Together those analyses suggested (i) measurement difficulties with some aspects of the opiate dependence syndrome and (ii) only a modest relationship between subjects' self-report and clinicians' judgements of severity of opiate dependence.
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