Profiling adolescent substance abusers by therapeutic alliance

Leslie Alkalay, Fordham University


There has been a lack of focus on treatment process in the child and adolescent psychotherapy literature in general, and in the adolescent substance abuse literature in particular. The current study was designed to address this gap in the literature by examining differences between adolescents who establish strong therapeutic alliances and those who form weak therapeutic alliances in the initial phase of treatment for substance abuse (i.e., Multidimensional Family Therapy (MDFT) and Cognitive-Behavioral Therapy (CBT)). This study also examined the relationship between alliance and outcome and considered the influence of patient variables on the development of therapeutic alliance. The person-centered approach taken in this study emphasized the importance of the person as the major unit of analysis rather than as variables analyzed separately. Subjects were 113 substance-abusing, juvenile justice involved adolescents originally recruited to participate in an outcome study comparing the efficacy of MDFT and CBT, who were divided into high-scoring-alliance and low-scoring-alliance extreme groups on the basis of their Vanderbilt Therapeutic Alliance Scale-Revised scores by means of a tertile split. High- and low-alliance groups were compared with respect to demographic information, drug use symptomatology, internalizing and externalizing behaviors, family functioning, and self-worth. Contrary to prediction, alliance groups could not be distinguished on the basis of these variables. Therapeutic alliance was overall not found to be associated with adolescent outcome. No significant effects of treatment condition were found. Implications of the findings for future process studies are discussed, as are the developmental implications of the findings.

Subject Area


Recommended Citation

Alkalay, Leslie, "Profiling adolescent substance abusers by therapeutic alliance" (2006). ETD Collection for Fordham University. AAI3216902.