Attachment and Therapeutic Alliance in Substance Use Disorders: Initial Findings for Treatment in the Therapeutic Community

Background: There is convincing evidence that individuals suffering from Substance Use Disorder (SUD) often present insecure attachment patterns. In contrast, a strong therapeutic alliance in treatment of SUD has been found to lead to a more positive treatment outcome. However, insecure attachment h...

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Autores principales:	Leonie L. Rübig, Jürgen Fuchshuber, Pia Köldorfer, Anita Rinner, Andreas Fink, Human-Friedrich Unterrainer
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	substance use disorder therapeutic alliance working alliance dimensions therapeutic community attachment Psychiatry RC435-571
Acceso en línea:	https://doaj.org/article/213c15592b98423bb0e04824a894cb40
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spelling	oai:doaj.org-article:213c15592b98423bb0e04824a894cb402021-11-10T07:12:05ZAttachment and Therapeutic Alliance in Substance Use Disorders: Initial Findings for Treatment in the Therapeutic Community1664-064010.3389/fpsyt.2021.730876https://doaj.org/article/213c15592b98423bb0e04824a894cb402021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fpsyt.2021.730876/fullhttps://doaj.org/toc/1664-0640Background: There is convincing evidence that individuals suffering from Substance Use Disorder (SUD) often present insecure attachment patterns. In contrast, a strong therapeutic alliance in treatment of SUD has been found to lead to a more positive treatment outcome. However, insecure attachment has been observed to be linked with weaker therapeutic alliance strength. The primary aim of this explorative study was to gain initial insights regarding the influence of attachment and personality characteristics on therapeutic alliance and therapy motivation in SUD patients undergoing treatment at a therapeutic community. Furthermore, SUD patients were compared to healthy controls regarding attachment, personality and mood pathology.Methods: A total sample of 68 participants, 34 inpatients in SUD treatment and 34 age-gender and education adjusted controls, were investigated. Both groups filled in the Adult Attachment Scale (AAS), the Inventory of Personality Organization (IPO-16), and the Brief Symptom Inventory (BSI-18) questionnaires. Additionally, SUD patients filled in the Working Alliance Inventory (WAI-SR) and the adapted German version of the University of Rhode Island Change Assessment scale (FEVER).Results: In line with our assumptions, SUD patients exhibited a decreased amount of attachment security (AAS) which was related to higher personality (IPO-16) and mood pathology (BSI-18). Furthermore, correlational analysis revealed the WAI-SR dimension Bond being positively associated with more secure attachment. A strong task alliance was linked to the Action stage of change (FEVER) and decreased mood but not personality pathology.Conclusion: Our findings confirm the putative negative effect of attachment and personality pathology on therapy motivation and therapeutic alliance in addiction therapy as well as more specifically in therapeutic community treatment. Future research in enhanced samples might focus more on the long-term effects of the interaction of attachment, personality and therapeutic alliance variables.Leonie L. RübigLeonie L. RübigJürgen FuchshuberJürgen FuchshuberPia KöldorferAnita RinnerAndreas FinkHuman-Friedrich UnterrainerHuman-Friedrich UnterrainerHuman-Friedrich UnterrainerFrontiers Media S.A.articlesubstance use disordertherapeutic allianceworking alliance dimensionstherapeutic communityattachmentPsychiatryRC435-571ENFrontiers in Psychiatry, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	substance use disorder therapeutic alliance working alliance dimensions therapeutic community attachment Psychiatry RC435-571
spellingShingle	substance use disorder therapeutic alliance working alliance dimensions therapeutic community attachment Psychiatry RC435-571 Leonie L. Rübig Leonie L. Rübig Jürgen Fuchshuber Jürgen Fuchshuber Pia Köldorfer Anita Rinner Andreas Fink Human-Friedrich Unterrainer Human-Friedrich Unterrainer Human-Friedrich Unterrainer Attachment and Therapeutic Alliance in Substance Use Disorders: Initial Findings for Treatment in the Therapeutic Community
description	Background: There is convincing evidence that individuals suffering from Substance Use Disorder (SUD) often present insecure attachment patterns. In contrast, a strong therapeutic alliance in treatment of SUD has been found to lead to a more positive treatment outcome. However, insecure attachment has been observed to be linked with weaker therapeutic alliance strength. The primary aim of this explorative study was to gain initial insights regarding the influence of attachment and personality characteristics on therapeutic alliance and therapy motivation in SUD patients undergoing treatment at a therapeutic community. Furthermore, SUD patients were compared to healthy controls regarding attachment, personality and mood pathology.Methods: A total sample of 68 participants, 34 inpatients in SUD treatment and 34 age-gender and education adjusted controls, were investigated. Both groups filled in the Adult Attachment Scale (AAS), the Inventory of Personality Organization (IPO-16), and the Brief Symptom Inventory (BSI-18) questionnaires. Additionally, SUD patients filled in the Working Alliance Inventory (WAI-SR) and the adapted German version of the University of Rhode Island Change Assessment scale (FEVER).Results: In line with our assumptions, SUD patients exhibited a decreased amount of attachment security (AAS) which was related to higher personality (IPO-16) and mood pathology (BSI-18). Furthermore, correlational analysis revealed the WAI-SR dimension Bond being positively associated with more secure attachment. A strong task alliance was linked to the Action stage of change (FEVER) and decreased mood but not personality pathology.Conclusion: Our findings confirm the putative negative effect of attachment and personality pathology on therapy motivation and therapeutic alliance in addiction therapy as well as more specifically in therapeutic community treatment. Future research in enhanced samples might focus more on the long-term effects of the interaction of attachment, personality and therapeutic alliance variables.
format	article
author	Leonie L. Rübig Leonie L. Rübig Jürgen Fuchshuber Jürgen Fuchshuber Pia Köldorfer Anita Rinner Andreas Fink Human-Friedrich Unterrainer Human-Friedrich Unterrainer Human-Friedrich Unterrainer
author_facet	Leonie L. Rübig Leonie L. Rübig Jürgen Fuchshuber Jürgen Fuchshuber Pia Köldorfer Anita Rinner Andreas Fink Human-Friedrich Unterrainer Human-Friedrich Unterrainer Human-Friedrich Unterrainer
author_sort	Leonie L. Rübig
title	Attachment and Therapeutic Alliance in Substance Use Disorders: Initial Findings for Treatment in the Therapeutic Community
title_short	Attachment and Therapeutic Alliance in Substance Use Disorders: Initial Findings for Treatment in the Therapeutic Community
title_full	Attachment and Therapeutic Alliance in Substance Use Disorders: Initial Findings for Treatment in the Therapeutic Community
title_fullStr	Attachment and Therapeutic Alliance in Substance Use Disorders: Initial Findings for Treatment in the Therapeutic Community
title_full_unstemmed	Attachment and Therapeutic Alliance in Substance Use Disorders: Initial Findings for Treatment in the Therapeutic Community
title_sort	attachment and therapeutic alliance in substance use disorders: initial findings for treatment in the therapeutic community
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/213c15592b98423bb0e04824a894cb40
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Attachment and Therapeutic Alliance in Substance Use Disorders: Initial Findings for Treatment in the Therapeutic Community

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