THERAPISTS' EMOTIONAL REACTIONS TO SUBSTANCE ABUSERS: A NEW QUESTIONNAIRE AND INITIAL FINDINGS

Therapists' emotional responses to substance abuse patients have long been hypothesized to impact on treatment, but have rarely been studied. This article reports results for a new scale developed for this purpose, Ratings of Emotional Attitudes to Clients by Treaters (REACT). The REACT was administered to 52 therapists and 140 cocaine-dependent outpatients, at sessions 2, 5, and 24 of psychotherapy. It was found to have high internal consistency at each time point, moderately high convergent validity with therapists' (but not patients') therapeutic alliance ratings, and a factor structure that appeared to meaningfully derive four factors: "therapist in conflict with self," "therapist focused on own needs," "positive connection," and "therapist in conflict with the patient." Therapists' emotional responses were found to become more negative over the course of treatment, and, when compared by theoretical orientation, were found more positive for 12-step drug counselors than for cognitive or supportive-expressive therapists.