Individual, Family, and Community Education ETDs

Publication Date

Spring 4-20-2020


Effects of therapeutic alliance has been widely studied for depression, anxiety, and interpersonal problems and been found to have small to moderate positive outcomes. Consistent findings are lacking, however, regarding the relationship between therapeutic alliance, treatment therapy, and client characteristics, in alcohol use disorder (AUD) treatment.

The current paper utilizes data from Project MATCH to assess the differential effects of therapeutic alliance on 12-month alcohol abstinence across clients receiving Cognitive Behavioral Therapy (CBT), Motivational Enhancement Therapy (MET), and Twelve Step Facilitation (TSF) treatment. Moreover, higher order interactions were explored to determine whether such effects differed across client characteristics. This research study had several important implications pertaining to the investigation of therapeutic alliance, a construct which has been inherently difficult to measure, through the utilization of covariate balancing propensity scores (CBPS).

As such, individuals with low levels of interpersonal dependency were found to be less likely to benefit from therapeutic alliance in achieving alcohol abstinence receiving CBT, whereas, when paired with higher therapeutic alliance, individuals with high levels of interpersonal dependency were more likely to be alcohol abstinent at 12-months. Interestingly, the same effects were not found in TSF or MET, suggesting therapeutic alliance might function differentially across treatment therapies, as well.


Alcohol Use Disorder, Treatment, Therapeutic Alliance, Differential Effects, Propensity Scores

Document Type




Degree Name

Educational Psychology

Level of Degree


Department Name

Individual, Family, and Community Education

First Committee Member (Chair)

Dr. Lee Van Horn

Second Committee Member

Dr. Terri Flowerday

Third Committee Member

Dr. Carolyn Hushman