Significance of the Problem

• The therapeutic alliance is a strong predictor of treatment outcomes, but therapeutic alliances with clients who have co-occurring disorders can be challenging.
• Counselors who have problems managing their feelings and biases or who are not empathic will experience problems maintaining therapeutic alliances with clients with co-occurring disorders.
• Clients with co-occurring disorders often have problems related to treatment engagement, motivation for change, cognitive deficits, and a reluctance to participate in self-help groups.
• By applying simple guidelines and techniques, counselors can improve outcomes and therapeutic alliances with their clients who have co-occurring disorders.