A Relational Investigation of the Therapeutic Alliance in Substance Abuse Treatment: A Qualitative Study

Abstract

Phenomenological inquiry was utilized to explore clients’ lived experiences with the therapeutic alliance in substance abuse treatment at a low intensity residential treatment center in East-Central Minnesota. Five females and ten males ranging in ages between 20-55 years of age participated in individual interviews. Moustakas’s (1994) modification of the Stevick-Colaizzi-Keen method was the approach utilized for data analysis. The researcher identified several themes and subthemes during data analysis. The researcher identified four major themes (Working with their counselor helped clients learn about themselves; Mutuality deepened the client-counselor relationship; Clients valued their counselors connecting them with resources; and Clients appreciated that their counselors held them accountable by inquiring about behaviors or progress toward identified goals). Several subthemes were identified (Uncovering hidden insights; Counselor genuine self-disclosure as a means of establishing mutuality and relatability; and Counselors sharing emotion). A relational framework was utilized to address alliance formation issues unique to addiction treatment, specifically client engagement. Implications for practice and research will be discussed.