The relationship of counselor and peer alliance to drug use and HIV risk behaviors in a six-month methadone detoxification program

• Published in: Addictive behaviors Vol. 20; no. 3; pp. 395 - 405
• Main Authors: Tunis, Sandra L., Delucchi, Kevin L., Schwartz, Kim, Banys, Peter, Sees, Karen L.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.05.1995; New York, NY Elsevier; Elsevier Science Ltd
• Subjects: Biological and medical sciences; Counseling; Desintoxication. Drug withdrawal; Drug abuse; HIV; HIV Seropositivity - transmission; Human immunodeficiency virus; Humans; Inactivation, Metabolic; Medical sciences; Methadone - therapeutic use; Peer Group; Professional relationships; Professional-Patient Relations; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Risk-Taking; Sexual Behavior; Substance abuse treatment; Substance-Related Disorders - drug therapy; Treatment Outcome; Treatments; Human; Drug addiction; Replacement therapy; Peer relation; Poison withdrawal; Treatment efficiency; Opiates; AIDS; Risk taking; Narcotic analgesic; Infection; Client counselor relation; Social interaction; Viral disease; Evolution
• ISSN: 0306-4603; 1873-6327
• DOI: 10.1016/0306-4603(94)00080-I

The purpose of this study was to examine the relationship of treatment outcomes in opioid detoxification to levels of counselor and peer alliance. Forty-one subjects were recruited from a larger, 180-day study of psychosocial treatment. Beginning at day 90 subjects completed monthly measures of alliance. Outcome measures included treatment retention, drug use, and self-reported HIV risk. Measures of alliance were found to be internally consistent and moderately stable over time. During the final 30 days of the methadone taper, higher levels of both types of alliance were associated with less use of illicit opioids. Alliance with counselor was associated with less frequent needle sharing. For subjects who could be located for 30-day follow-up, greater alliance with peers was associated with more frequent HIV (sexual) risk behaviors. Results suggest that treatment outcome may be improved through approaches that address a patient's alliance with both counselor and peers.