Carol Foltz

Therapeutic alliance as a predictor of outcome and retention in the National Institute on Drug Abuse Collaborative Cocaine Treatment Study.

The authors examined the relation between therapeutic alliance, retention, and outcome for 308 cocaine-dependent outpatients participating in the National Institute on Drug Abuse Collaborative Cocaine Treatment Study. High levels of alliance were observed in supportive-expressive therapy (SE), cognitive therapy (CT), and individual drug counseling (IDC), and alliance levels increased slightly but significantly from Session 2 to Session 5 in all groups. In contrast to other studies, alliance was not a significant predictor of drug outcome. However, alliance did predict patient retention differentially across the 3 treatments. In SE and IDC, either higher levels of alliance were associated with increased retention or no relationship between alliance and retention was found, depending on the time alliance was measured. In CT, higher levels of alliance were associated with decreased retention.

Parental communication of Holocaust experiences and interpersonal patterns in offspring of Holocaust survivors

This study examined the interpersonal problems and central relationship patterns of Holocaust Survivors’ Offspring (HSO) who were characterised by different patterns of parental communication of their parents’ Holocaust trauma. Fifty-six adults born to mothers who were survivors of Nazi concentration camps and 54 adults born to parents who immigrated to Israel before 1939 with their own parents (non-HSO) were recruited randomly from an Israeli sample. While the groups did not differ in their current mental health, HSO who reported nonverbal communication with little information about their mother’s trauma endorsed more interpersonal distress than HSO who experienced informative verbal communication and less affiliation than either HSO who experienced informative verbal communication or non-HSO. They also differed in their central relationship patterns with their parents and spouses. The findings are discussed in the context of the unique dynamics of growing up with the silent presence of the mother’s trauma.

Recidivism Among High-Risk Drug Felons: A Longitudinal Analysis Following Residential Treatment

Abstract Recent interest in increasing access to substance abuse treatment for drug-involved offenders has been spurred by concerns over expanding prison and jail populations, high recidivism rates for drug-involved offenders, and the close link between illegal drug use and criminal activity. Chronic untreated drug and alcohol abuse is likely to result in high rates of repeated contacts with the criminal justice system and a greater likelihood of reincarceration. Unless these offenders naturally desist from drug use, or are successfully engaged in treatment, recidivism is likely to remain high and the courts and correctional systems are likely to continue to be overwhelmed by large numbers of drug-involved offenders. This article uses multiple recidivism measures to assess the long-term effects of diversion to a highly coercive, long-term residential therapeutic community treatment for repeat felony drug offenders charged with drug sales and facing mandatory incarceration in state prison. If the offenders completed the 18-24 month program, all charges were dismissed; dropouts were returned to court for prosecution and sentenced to state prison. Compared with a closely matched sample of offenders sentenced to prison, Drug Treatment Alternative to Prison (DTAP) program participation generally reduced the prevalence and annual rate (adjusting for time in the community) of recidivism, and delayed time to first rearrest. In multivariate models of rearrest prevalence and adjusted annual rearrest rate, DTAP program participation was related to lower recidivism at significance levels between .05 and .10, after controlling for criminal history and other covariates. These findings suggest that diverting high-risk, prison-bound felony drug sellers to long-term treatment can yield significant, long-term reductions in recidivism.

Self and observer reports of interpersonal problems in couples

This study investigated self-partner agreement on a measure of interpersonal problems as well as the relationship between discrepancy in self-partner ratings and self-reported symptomatology. Both partners of 49 young adult couples rated themselves and their partners on the Inventory of Interpersonal Problems(IIP Horowitz, Rosenberg, Baer, Ureño, & Villaseñor, 1988). The results demonstrated that couples generally evidenced significant agreement in characterizing the interpersonal problems of each target person, suggesting that the substantial self-partner agreement previously reported for personality traits generalizes to the domain of interpersonal problems. Results also indicated that the relationship between self-partner discrepancy and symptomatology depended on the target persons gender. Finally, the data provide preliminary evidence of the psychometric properties of an observer form of the IIP, including its circular structure.

Issues in research on short-term dynamic psychotherapy.

In this article, we review the development of short-term dynamic psychotherapy (STDP) and introduce some of the important questions to be addressed in studying STDP. We begin by surveying some of the areas not covered in this special edition (e.g., the efficacy of STDP, recent developments in dynamic formulation) because they were recently reviewed elsewhere. We then introduce the four articles included in this special mini-series. We conclude by looking at which questions could benefit from further study and recommend that more data be gathered regarding (a) the differences between the many different forms of STDP; (b) the efficacy of these forms of therapies for specific disorders, including personality disorders; (c) the essential theoretically relevant processes occurring in those treatments; (d) matching patients to different therapies; (e) the interrelations between different therapeutic processes; and (f) the different strategies for teaching STDP.