The aim of this study is to investigate the construction of a Therapeutic Alliance (TA) with heroin users in charge of the Public Drug Addiction Services (PDAS) of the Tuscan Region. Thirty therapists working in the Services of each of the 12 Local Unit of the Tuscan Public Health Service participated in this study. We used the following working instruments: the Working Alliance Inventory (WAI) (Horvath, 1981, 1982), a form to collect the users’ data and a semi-structured interview to collect the therapists’ opinions. It emerged from the results that some characteristics of the patients are able to negatively affect the construction of a TA. In relation to such characteristics, there seem to exist some important differences about the modalities used by the interviewed therapists in order to build the TA, aimed at increasing the length of their intervention, reduce the drop-out rate and enhance the effectiveness of the treatment.
Keywords: Therapeutic Alliance; Working Alliance; Helping Alliance; Drug Dependence