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Therapist effects in three treatments for alcohol problems

  • John P. Allen
  • , Margaret E. Mattson
  • , William R. Miller
  • , J. Scott Tonigan
  • , Gerard J. Connors
  • , Robert G. Rychtarik
  • , Carrie L. Randall
  • , Raymond F. Anton
  • , Ronald M. Kadden
  • , Mark Litt
  • , Ned L. Cooney
  • , Carlo C. Diclemente
  • , Joseph Carbonari
  • , Allen Zweben
  • , Richard H. Longabaugh
  • , Robert L. Stout
  • , Dennis Donovan
  • , Thomas F. Babor
  • , Frances K. Delboca
  • , Bruce J. Rounsaville
  • Kathleen M. Carroll, Philip W. Wirtz
  • National Institutes of Health
  • University of New Mexico
  • Medical University of South Carolina
  • University of Connecticut
  • Yale University
  • University of Houston
  • University of Wisconsin-Milwaukee
  • Brown University
  • University of Washington
  • George Washington University

Research output: Contribution to journalArticlepeer-review

163 Scopus citations

Abstract

Prior research indicates that therapist effects can be sizeable in substance- abuse treatment. Therapist differences were examined within a multisite (TV = 1726) randomized trial of three psychosocial treatments for alcohol problems: twelve-step facilitation (TSF), cognitive-behavioral skills training (CBT), and motivational enhancement therapy (MET). Therapists (TV = 80) were nested within treatments, selected and trained for expertise in a specific approach. This report describes: (1) differences in therapist characteristics across the three treatments; (2) the magni-tude of therapist effects within each treatment; and (3) exploratory analyses of therapist attributes associated with successful outcomes. Therapist characteristics differed between TSF and the other two conditions. Significant therapist effects were found in client satisfaction and out-comes, even after covarying for effects of treatment sites and client baseline characteristics. Specific therapist attributes were predictive of client outcomes. Outlier therapists whose caseloads showed unusually poor outcomes accounted for most of the observed effects.

Original languageEnglish
Pages (from-to)455-474
Number of pages20
JournalPsychotherapy Research
Volume8
Issue number4
DOIs
StatePublished - Jul 1998

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