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Substance use disorders and racial/ethnic minorities matter: a meta-analytic examination of the relation between alliance and outcome.

Flückiger C, Del Re AC, Horvath AO, Symonds D, Ackert M, Wampold BE. Substance use disorders and racial/ethnic minorities matter: a meta-analytic examination of the relation between alliance and outcome. Journal of counseling psychology. 2013 Oct 1; 60(4):610-6.

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Abstract:

The purpose of this meta analysis was to examine the moderating impact of substance use disorder as inclusion/exclusion criterion as well as the percentage of racial/ethnic minorities on the strength of the alliance-outcome relationship in psychotherapy. It was hypothesized that the presence of a Diagnostic and Statistical Manual of Mental Disorders (DSM) Axis I substance use disorder as a criterion and the presence of racial/ethnic minorities as a sociocultural indicator are moderately correlated client factors reducing the relationship between alliance and outcome. A random effects restricted maximum-likelihood estimator was used for omnibus and moderator models (k = 94). The presence of (a) substance use disorder and (b) racial/ethnic minorities (overall and specific to African Americans) partially moderated the alliance-outcome correlation. The percentage of substance use disorders and racial/ethnic minority status was unexpectedly highly correlated in the present treatment research samples. Sociocultural contextual variables should be considered along with a DSM Axis I diagnosis of substance use disorders in analyzing and interpreting therapy process variables such as the alliance.




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