Attachment style, early maladaptive schemas, coping self -efficacy, therapy alliance and their influence on addiction severity in methadone -maintenance treatment

Bradley Roger Brummett, Fordham University


This study examined the interrelationships between attachment style, early maladaptive schemas, therapy alliance, coping self-efficacy, and addiction severity. In addition to investigating associations between the aforementioned constructs, the study also tested hypotheses that therapy alliance and coping self-efficacy would separately moderate the relationships of both attachment style and early maladaptive schemas with addiction severity. The sample consisted of 121 methadone-maintained outpatient adults. Participants were evenly divided between male and female, predominately racial/ethnic minorities, and the majority were working class. The moderating effects of therapy alliance and coping self-efficacy were analyzed using hierarchical multiple regression. Results indicated relationships between anxious attachment, early maladaptive schemas, and coping self-efficacy with addiction severity in hypothesized directions. There was no association observed between therapy alliance and addiction severity. Results also indicated that anxious attachment was associated with addiction severity, and therapy alliance played a moderating role in the relationship between anxious attachment and addiction severity (exclusively for participants who indicated having psychological problems). No moderation effects were observed for coping self-efficacy. Findings support the integration of psychotherapeutic elements into substance abuse treatment, particularly for clients with anxious attachment or early maladaptive schemas. Specifically, a stronger client-counselor relationship could reduce addiction for those who suffer anxiety over their attachments to others. The lack of support for coping self-efficacy as a moderator challenged previous research and suggested that this construct may exert more influence for certain populations and stages of treatment.

Subject Area

Psychotherapy|Cognitive therapy

Recommended Citation

Brummett, Bradley Roger, "Attachment style, early maladaptive schemas, coping self -efficacy, therapy alliance and their influence on addiction severity in methadone -maintenance treatment" (2007). ETD Collection for Fordham University. AAI3286413.