Exploring whether the working alliance is a mediator between client resistance, therapist directiveness, and drinking outcomes in an alcohol dependent population.

Abstract

This study aims to elucidate whether the working alliance mediates the relationship between client resistance, therapist directiveness, and short and long-term drinking outcomes in an alcohol dependent population. The relationship between client resistance, therapist directiveness, and drinking outcomes has recently been examined in working with an Alcohol Use Disordered (AUD) population (Karno & Longabaugh, 2005a; Karno & Longabaugh, 2005b; Karno, Longabaugh, & Herbeck, 2010). For instance, Karno and Longabaugh (2005a, 2005b) found that levels of therapist directiveness differentially affect client resistance which, when taken together, predicts treatment outcomes, such as drinks per drinking day (D/DD) and percentage of days abstinent (PDA). The current study builds on the research of Karno and Longabaugh (2005a, 2005b) in proposing that therapist directiveness and client resistance affect client drinking outcomes through a mediator: the working alliance. This study found that the working alliance does not mediate the relationship between client resistance and short and long-term drinking outcomes, and between therapist directiveness and short and long-term drinking outcomes.