Opioid abuse costs affect the majority of the adult population in our society directly or indirectly. The current prevailing medical treatment for opioid addiction is methadone maintenance treatment (MMT). MMT reduces infectious disease spread, illicit drug use, criminal activity, and overdose potential. MMT is only as effective as the length of time a client remains active and compliant with the program. In previous studies, therapeutic alliance (TA) has been shown to positively influence the effectiveness of substance abuse treatment. However, a gap exists in research in regards to the impact of TA on the effectiveness of MMT outcomes. The theoretical framework of this study is based on therapeutic alliance, which guided an examination on whether therapeutic alliance (as measured by the Session Rating Scale) influenced MMT retention and compliance (drug screens and session attendance). Archival data from 264 clients receiving MMT for opioid dependence were reviewed from a nonprofit community-based agency in Arizona. Logistic regression results revealed that TA did not significantly affect retention or compliance. However, issues were noted such as how the SRS was administered, a lack of understanding by clients regarding scoring the SRS, and unique social desirability demands when clients are in MMT. The finding that TA alone did not significantly affect retention and compliance does not decrease the need to find effective means to improve MMT outcomes. Rather, the findings suggest a critical need to identify and utilize measures more appropriate for clients receiving MMT. In doing so, positive social change may be achieved by assisting clinical staff in developing a strong therapeutic alliance with MMT clients as they focus on problem solving as a joint venture when challenges in the recovery process arise.

Följande studie handlar om feedbackorienterad terapi på Familjerådgivningen. Syftet var att mäta parens upplevda förändring av livstillfredsställelse för att se om samtalen på Familjerådgivningen gör skillnad och om förändringen enligt skattningsinstrumenten ORS och SRS överensstämde med skattningen av klimatet i parrelationen/familjen samt om det fanns några könsskillnader. Undersökningsgruppen omfattades av 29 par, som sökte hjälp på Familjerådgivningen i södra Dalarna, i Mora och i Linköping under tiden januari 2016 till maj 2016. Paren fyllde i skattningsinstrumentet ORS (som mäter förändring) i början av varje samtal och SRS (som mäter alliansen) i slutet av varje samtal. Familjerådgivaren använde sig av den feedback som gavs och korrigerade behandlingen därefter. Vid första och tredje samtalet fyllde paren i skattningsinstrumentet "Familjeklimat". Resultatet efter tre samtal visade en liten förbättring av livstillfredsställelse för både män och kvinnor vilket överensstämde med skattningen av klimatet i familjen där närheten förbättrades och kaos minskade. / The following study is about feedback informed treatment in family councelling. The purpose was to measure the couples experienced change in life satisfaction, to see if treatment sessions of family councelling makes a difference and change according to the estimation instruments ORS and SRS and is consistent with the estimate of the atmosphere in the couple´s relationship/family atmosphere and if there were any gender differences. The study group included 29 couples who sought help at the Family councelling in southern Dalarna, Mora and Linköping during the period of January 2016 to May 2016. The couples filled in the instrument ORS (measuring change) at the beginning of each session and SRS (measuring alliance) at the end of each session. The family councellor used the received feedback and corrected treatment accordingly. In the first and third session the couples filled in the "Family climate" instrument. The outcome after three sessions showed a small improvement in the life satisfaction for both men and women which were consistent with the estimate of the atmosphere and the climate in the family. The vicinity improved and chaos decreased.

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