Therapeutic alliance in psychological treatment for depression and alcohol use comorbidity: The client's perspective

This qualitative study explored the treatment experience and the therapeutic relationship of participants receiving an integrated psychological treatment for comorbid alcohol use problems and depressive disorders. Semistructured interviews targeting experience of therapy and the relationship with the therapist were carried out with seven participants. Transcripts were analyzed using Interpretive Phenomenological Analysis to reveal major themes. Four major themes were identified. "Nature of the relationship" describes the importance of the client's perception of the therapeutic relationship experienced, "Confidence in therapy" and "Acknowledgment of experience" address components assisting the development of a positive alliance, and "Meeting unmet needs for connection" illustrates the importance of a positive therapeutic relationship for this population. Participants thought that clinicians would benefit from a good understanding of the role the alliance relationship plays within comorbidity treatment, of the need this relationship meets for this population, and the importance of engendering confidence in therapy and recognizing client perspectives.