Effective therapists foster "alliances'
Researchers at the University of Pennsylvania in Philadelphia recently discovered that opiate-addicted men improve far more when drug counseling is combined with psychotherapy. They noticed, however, that the patients of some therapists did markedly better than the patients of others.
The scientists found that the most successful therapists are seen by patients as helpful during the first few treatment sessions. A "helping alliance,' or cooperative patient-therapist relationship, is the result. This sets the stage for a therapist to effectively use specific techniques, such as interpreting conflicts behind symptoms or identifying problem behaviors. Without a helping alliance, any number of therapy approaches are likely to fall flat, report Lester Luborsky and colleagues in the June ARCHIVES OF GENERAL PSYCHIATRY.
Clinicians have long assumed that a therapist's personal qualities play a role in the success or failure of psychotherapy, but "there is a remarkable lack of tested information on the topic,' say the investigators.
They randomly assigned 110 male opiate addicts to one of three treatments: drug counseling, psychoanalytically oriented psychotherapy with drug counseling, or cognitive …