The interactive role of working alliance and counselor-client interpersonal behaviors in adolescent substance abuse treatment

Abstract

This descriptive study explored the relationship between client and counselor perceptions of the working alliance and the interpersonal relationship dimensions of affiliation and control, and evaluated the relationship of perceptions of the alliance and of client and counselor interpersonal reactions to each other to client outcome after 3-6 months of treatment for substance abuse. Clients were 39 adolescents. Client and counselor ratings of the working alliance (using the Working Alliance Inventory-WAI) and interpersonal appraisals of each other (using the Impact Message Inventory Circumplex-IMI-C) were obtained during the second week of treatment. Outcome data using the Global Appraisal of Individual Needs (GAIN) and the Child and Adolescent Functional Assessment Scale (CAFAS) were obtained during the second week of treatment and again after three months and six months of treatment. Interpersonally the predominant impact clients and counselors had on each other was friendliness. For both clients and counselors feelings of affiliation with their counterpart was the relationship dimension most strongly associated with the perception of a working alliance. These findings, and significant associations obtained between WAI and IMI measures and outcome measures, have implications for future research on the role of alliance and interpersonal variables in substance abuse clients¿ response to treatment.