TitleThe effects of therapeutic alliance and client readiness to change on cognitive behavior therapy treatment outcomes for a sample of substance and non-substance abusing psychiatric inpatient women
NameClarke, Nickeisha (author), Kely, Shalonda (chair), Mun, Eun-Young (co-chair), Lynch, Katherine (outside member), Rutgers University, Graduate School of Applied and Professional Psychology,
Women—Mental health services
DescriptionInpatient women with psychiatric and substance abuse problems have higher rates of relapse and non-compliance with medication and treatment, and poorer treatment prognoses and general outcomes, compared to their non substance-abusing counterparts (Kavanagh & Mueser, 2007). The present study examined whether therapeutic alliance and client readiness to change that are known to predict improved treatment outcomes predict better treatment outcomes among women with or without a substance abuse history that are receiving acute psychiatric inpatient treatment. This study examined the hypothesis that women with comorbid substance abuse problems receiving cognitive-behavioral therapy (CBT) on an acute inpatient unit would benefit more from high readiness to change and therapeutic alliance than their counterparts without comorbid substance use problems. The sample consisted of 117 women receiving concurrent CBT and pharmacotherapy treatment on an acute inpatient unit at a major metropolitan hospital. Self-report measures of therapeutic alliance, psychological functioning, and alcohol and drug abuse were administered within 72 hours of their admission, every 7 days post admission date, and 24 hours prior to discharge. Repeated measures analysis of variance and multiple regression analyses were conducted to examine the relationship between alliance, motivation, treatment group, and psychological functioning at discharge. Results indicated that women in both treatment groups made significant improvements in psychological functioning from admission to discharge. Also, high levels of readiness to change at admission and high levels of therapeutic alliance at discharge were linked to better overall psychological functioning at discharge for both treatment groups. The hypotheses previously mentioned were not supported, that is, the two groups did not statistically differ in the relationship between alliance, readiness to change, and treatment outcomes. Findings from this study suggest that women with comorbid substance use disorders experiencing more acute psychological distress at admission seemed to benefit from an intensive, supportive, and structured CBT inpatient program just as much as their counterparts without a comorbid substance use problem. Similarly, alliance and readiness to change do play a significant role in improving outcomes for women after an acute psychiatric inpatient hospitalization, despite having a substance abuse history. More studies are needed to examine the link between alliance, readiness to change, and treatment outcomes in order to promote recovery by providing the most effective treatment for patients with and without a substance abuse history.
NoteIncludes bibliographical references
Noteby Nickeisha Clarke
CollectionGraduate School of Applied and Professional Psychology Electronic Theses and Dissertations
Organization NameRutgers, The State University of New Jersey
RightsThe author owns the copyright to this work.