The client–therapist relationship
 The client–therapist relationship

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The client–therapist relationship

At the heart of addiction treatment lies client–therapist relationships, across psychosocial therapies a stronger influence on how well clients do than the type of therapy. A collection starting with the analyses most recently added or updated, totalling today 81 documents.

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STUDY 2011 HTM file
Therapist effectiveness: implications for accountability and patient care

1 in 6 US therapists (mainly not specialising in substance use) typically ended up with clients whose substance use problems were significantly worse than when they started therapy, an indication perhaps that social workers and mental health counsellors find these issues especially hard to deal with.

STUDY 2011 HTM file
Shared decision-making: increases autonomy in substance-dependent patients

An innovative Dutch study tested a way of involving substance users as equals in decisions over issues addressed in their treatment. The effect was to give these typically submissive personalities a greater sense of control over their lives. Just as influential was the lead offered by the clinician's personality.

ABSTRACT 2011 HTM file
Evidence-based therapy relationships: research conclusions and clinical practices

Draws conclusions and makes recommendations based on research syntheses commissioned by the American Psychological Association on effective therapeutic relationships and how to match therapeutic style to different patients – work critical to recovery from addiction.

REVIEW 2011 HTM file
Evidence-based psychotherapy relationships: Managing countertransference

This meta-analytic review commissioned by the American Psychological Association finds that therapists with the self-awareness and other abilities to recognise, understand and use their reactions to clients, even when these are driven by the therapist's own internal conflicts, do better therapy and have more satisfied clients.

REVIEW 2011 HTM file
Evidence-based psychotherapy relationships: Repairing alliance ruptures

This meta-analytic review commissioned by the American Psychological Association finds that repairing breakdowns in the alliance between therapist and client improves outcomes, and that 'rupture repair' training makes a difference, especially in the cognitive-behavioural approaches commonly used in addiction treatment.

REVIEW 2011 HTM file
Evidence-based psychotherapy relationships: Collecting client feedback

This meta-analytic review commissioned by the American Psychological Association finds outcomes improve (and clients doing poorly can be 'rescued') when therapists get real-time feedback on patient progress and the client-therapist relationship. Providers may want to consider one of the evaluated systems or an alternative.

ABSTRACT 2011 HTM file
Evidence-based psychotherapy relationships: Congruence/genuineness

This meta-analytic review commissioned by the American Psychological Association finds that in the (mainly Western) cultures where these studies have been done, outcomes improve the more therapists are seen as genuine by their clients and relating to them human to human rather than as an authority figure.

REVIEW 2011 HTM file
Evidence-based psychotherapy relationships: Goal consensus and collaboration

This meta-analytic review commissioned by the American Psychological Association finds that outcomes improve the more clients and therapists agree on goals and methods and form collaborative working relationships to implement those agreements. The findings support deep patient involvement in deciding treatment goals and methods.

REVIEW 2011 HTM file
Evidence-based psychotherapy relationships: Positive regard

This meta-analytic review commissioned by the American Psychological Association finds outcomes improve the more therapists are consistently warm and show high regard for clients. Given the stigma and low regard attached to addiction and addicts, these findings have important implications for promoting recovery.

REVIEW 2011 HTM file
Evidence-based psychotherapy relationships: Cohesion in group therapy

This meta-analytic review commissioned by the American Psychological Association suggests that fostering cohesion between leaders and groups, and within groups, is often an important way to improve group therapy outcomes. Practice recommendations will help group leaders make the most of this common substance use treatment format.


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