Therapeutic alliance and the retention of couples in conjoint alcoholism treatment

Differences were investigated in the degree to which less versus more experienced therapists formed a therapeutic alliance with their clients and how these differences were related to retaining couples in treatment. Two raters, using the Vanderbilt Therapeutic Alliance Scale (VTAS) and the Vanderbilt Negative Indicators Scale (VNIS), coded 15-minute audiotaped segments of the first treatment session for 66 couples participating in a randomized clinical trial of three types of couple therapy for alcoholism. Ten therapists, whose experience ranged from 15 years of postdoctoral practice to a 1 year predoctoral practicum, administered the treatment. Results indicated that the more experienced therapists scored significantly higher on the VTAS and lower on the VNIS than did the less experienced therapists. Therapists' scores on these scales were significantly related to number of treatment sessions attended and number of couples completing treatment, but not to treatment outcomes.