Objective: Common factors such as therapist empathy play an important role in treatment for
addictive behaviors. The present study was a secondary analysis designed to evaluate the
relationship between therapist empathy and alcohol treatment outcomes in data from a large,
multi-site randomized controlled trial. Method: Audio-recorded psychotherapy sessions for 38
therapists and 700 clients had been randomly selected for fidelity coding from the Combined
Behavioral Intervention condition of Project COMBINE. Sessions were evaluated by objective
raters for both specific content (coping with craving, building social skills and managing
negative mood) and relational components (empathy level of the therapist). Multilevel
modeling with clients nested within therapists evaluated drinks per week at the end of treatment.