Assessing Covariates of Drug Use Trajectories Among Adolescents Admitted to a Drug Addiction Center: Mental Health Problems, Therapeutic Alliance, and Treatment Persistence

Bertrand, Karine; Brunelle, Natacha; Richer, Isabelle; Beaudoin, Isabelle; Lemieux, Annie; Ménard, Jean‐Frédéric

doi:10.3109/10826084.2012.733903

Cited by 21 publications

(20 citation statements)

References 70 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Patients who used only alcohol did not seem to have any effect of the alliance, while patients who used drugs seemed to benefit from the allianceat least when assessed from the therapist's perspective. Bertrand et al (2013) argued that clinicians might become more involved with patients whose drug problems are more severe. Patients with drug or mixed drug abuse often have severe psychiatric problems, making the therapeutic alliance more important for engagement in the therapeutic work to find relief of suffering and symptomatic improvement.…”

Section: Discussionmentioning

confidence: 99%

The role of the working alliance in psychological treatment of substance use disorder outpatients

Gidhagen

Holmqvist

Philips

et al. 2020

Psychotherapy Research

View full text Add to dashboard Cite

The main objective of this study was to explore the relationship between alliance and treatment outcome of substance use disorder (SUD) outpatients in routine care. Attachment, type of substance use, and treatment orientation were analyzed as potential moderators of this relationship. Method: Ninety-nine SUD outpatients rated their psychological distress before every session. Patients and therapists rated the alliance after every session. At treatment start and end, the patient completed the Alcohol Use Disorders Identification Test (AUDIT), the Drug Use Disorders Identification Test (DUDIT), and the Experiences in Close Relationships (ECR-S). Data were analyzed using multilevel growth curve modeling and Dynamic Structural Equation Modeling (DSEM). Results: The associations between alliance and outcome on psychological distress and substance use were, on average, weak. Within-patient associations between patient-rated alliance and outcome were moderated by self-rated attachment. Type of abuse moderated associations between therapist-rated alliance and psychological distress. No moderating effect was found for treatment orientation. Conclusions: Patients' attachment style and type of abuse may have influenced the association between alliance and problem reduction. A larger sample size is needed to confirm these findings.

show abstract

Section: Discussionmentioning

confidence: 99%

The role of the working alliance in psychological treatment of substance use disorder outpatients

Gidhagen

Holmqvist

Philips

et al. 2020

Psychotherapy Research

View full text Add to dashboard Cite

show abstract

“…On the other hand, there are also studies demonstrating that a relatively large proportion of adolescents with substance use problems do not report any mental disorders or symptoms at initiation of treatment [10,13,14], and studies showing minor differences between young people with and without mental health problems with respect to treatment involvement, dropout rate and treatment outcome [15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Mental health problems among young people in substance abuse treatment in Sweden

Richert

Anderberg

Dahlberg

2020

Subst Abuse Treat Prev Policy

View full text Add to dashboard Cite

Background: Young people with substance use problems face a high risk of co-occurring mental health problems, something that may involve a more difficult life situation, social problems as well as worse treatment outcomes. The aim of this study is to analyse self-reported mental health problems among young people receiving outpatient treatment for substance use problems in Sweden. We explore what types of mental health problems are more or less predominant, and whether there are significant differences between boys and girls. In addition, we analyse how various mental health problems covary with indicators of substance abuse severity. Methods: The study is based on structured interviews with 1970 young people enrolled at outpatient clinics in 11 Swedish cities. The data was analysed through frequency-and averages-calculations, Chi-square tests and multivariate logistic regression analyses. Results: Self-reported mental health problems were common among the young people in the study. A relatively large percentage of the total group (34-54%) reported problems such as concentration difficulties, sleeping difficulties, anxiety and depression. At the same time, many of the young people did not report any symptoms and only a small group, about 20%, reported diagnosed mental health disorders. The results show substantial gender differences, with girls reporting significantly higher levels of mental health problems. Multivariate logistic regression analyses demonstrated significant associations between severity of drug use problems and anxiety, concentration difficulties, aggression, hallucinations and mental stress caused by experiences of trauma. Conclusions: Treatment needs are diverse within this group of young people who use drugs. Since girls report higher levels of all mental health problems, and a larger burden of psychosocial risk factors than boys, they are likely to require more comprehensive treatment interventions. The link between more severe drug problems and mental health problems points to the importance of exploring this relationship in treatment. A multidisciplinary approach, in which co-occurring problems can be addressed simultaneously, may be the best treatment form for many young people with drug problems.

show abstract

“…Nearly all extant studies either measure alliance at later sessions or measure alliance and outcome only at infrequent intervals (i.e., pre-/posttreatment, etc. ), thus not addressing the role of alliance and symptom change during early sessions (Bertrand et al, 2013; Bourion-Bedes et al, 2013; Guzder, Bond, Rabiau, Zelkowitz, & Rohar, 2011; Hogue et al, 2006; Kazdin & Durbin, 2012; Keeley, Geffken, Ricketts, McNamara, & Storch, 2011; Liber et al, 2010; Marcus, Kashy, Wintersteen, & Diamond, 2011). …”

mentioning

confidence: 99%

Therapeutic Alliance With Depressed Adolescents: Predictor or Outcome? Disentangling Temporal Confounds to Understand Early Improvement

Labouliere

Reyes

Shirk

et al. 2015

Journal of Clinical Child & Adolescent Psychology

View full text Add to dashboard Cite

Psychotherapy research reveals consistent associations between therapeutic alliance and treatment outcomes in the youth literature; however, past research frequently suffered measurement issues that obscured temporal relationships between alliance and symptomatology by measuring variables later in therapy, thereby precluding examination of important early changes. The current study aimed to explore the directions of effect between alliance and outcome early in therapy with adolescents by examining associations between first- and fourth-session therapeutic alliance and symptomatology. Thirty-four adolescents (~63% female, 38% ethnic/racial minority) participated in a school-based cognitive-behavioral therapy for adolescents with depression. Participants completed the Beck Depression Inventory at baseline and Session 4, and therapeutic alliance was coded from audiotapes of Sessions 1 and 4 by objective coders using the Alliance Observation Coding System. Autoregressive path analyses determined that first-session therapeutic alliance was a strong significant predictor of Session 4 depression symptoms, but pretreatment depression scores were not significantly predictive of subsequent therapeutic alliance. Adding reciprocal effects between alliance and depression scores did not adversely affect model fit, suggesting that reciprocal effects may exist. Early therapeutic alliance with adolescents is critical to fostering early gains in depressive symptomatology. Knowing alliance’s subsequent effect on youth outcomes, clinicians should increase effort to foster a strong relationship in early sessions and additional research should be conducted on the reciprocal effects of therapeutic alliance and treatment outcome in adolescence.

show abstract

Assessing Covariates of Drug Use Trajectories Among Adolescents Admitted to a Drug Addiction Center: Mental Health Problems, Therapeutic Alliance, and Treatment Persistence

Cited by 21 publications

References 70 publications

The role of the working alliance in psychological treatment of substance use disorder outpatients

The role of the working alliance in psychological treatment of substance use disorder outpatients

Mental health problems among young people in substance abuse treatment in Sweden

Therapeutic Alliance With Depressed Adolescents: Predictor or Outcome? Disentangling Temporal Confounds to Understand Early Improvement

Contact Info

Product

Resources

About