Person-related and Treatment-related Barriers to Alcohol Treatment

Treatment underutilization by persons with alcohol use disorder is well-documented. This study examined barriers to treatment at the latter stages of the treatment-seeking process, which was conceptualized as recognizing the problem, deciding that change is necessary, deciding that professional help is required, and seeking care. All participants identified themselves as having a drinking problem that was severe enough to warrant treatment. Differences between those who had (Treatment Seekers) and those who had not (Comparison Controls) sought treatment were evaluated, including the experience of person-related (e.g., shame) and treatment-related (e.g., cost) barriers. Person-related barriers were more commonly endorsed by both groups than treatment-related barriers. Comparison Controls were more likely to endorse both types of barriers, especially the preference for handling the problem without treatment. Treatment-related barriers were less relevant than person-related barriers at the latter stage of help seeking. The significance of barriers endured after accounting for other differences, such as drinking-related negative consequences. Treatment implications are discussed

The therapeutic alliance: Predicting outcome, determining pretreatment correlates, and assessing a feedback intervention

The therapeutic alliance has been accepted as a central component of the psychotherapeutic process. Numerous studies have been conducted on theories, measurement issues, and correlates of the alliance, however, researchers only recently have started to acknowledge the possibility of improving the initial development of the alliance. The present studies investigated three facets of the alliance, using it to predict outcome, examining its pretreatment predictors, and using inferential feedback in a pilot study to enhance its development. Results showed that the alliance significantly predicted outcome as measured by level of client distress, experience of overall symptoms, and unusual thinking. Client intake relationship impairment and racial match significantly predicted the quality of the alliance. Finally, there was no statistical support provided for the efficacy of the inferential feedback intervention conducted in the pilot study. Suggestions are made for improvements to the feedback intervention. In addition, directions for future research on the therapeutic alliance are discussed

A Behavioral Health Screening Measure for Use with Young Adults in Primary Care Settings

Many healthcare professionals argue that mental health assessment should be routinely incorporated into young adults\u27 medical health care. This project is an evaluation of the Behavioral Health Screening Measure (BHSM) that could be integrated into a primary healthcare setting to aid in the identification of mental illness in young adults. First, Receiver Operating Characteristics analysis was used to calculate a cutoff score that distinguishes a sample of 134 young adult outpatients and 233 young adult nonpatients. Second, a sample of 120 young adults that completed BHSM was divided into two groups by using the cutoff score. Analyses suggested that the two groups had significantly different scores on various measures of depression, anxiety, and general well-being. Results suggest that BHSM would be a valid screening instrument for detecting emotional problems in young adults