Treatment Adherence, Competence, and Outcome in Individual and Family Therapy for Adolescent Behavior Problems

This study examined the impact of treatment adherence and therapist competence on treatment outcome in a controlled trial of individual cognitive-behavioral therapy (CBT) and multidimensional family therapy (MDFT) for adolescent substance use and related behavior problems. Participants included 136...

Full description

Saved in:

Bibliographic Details
Published in:	Journal of consulting and clinical psychology 2008-08, Vol.76 (4), p.544-555
Main Authors:	Hogue, Aaron, Henderson, Craig E, Dauber, Sarah, Barajas, Priscilla C, Fried, Adam, Liddle, Howard A
Format:	Article
Language:	eng
Subjects:	Adherence Adolescent Adolescent Behavior Adolescent Psychotherapy Adolescents Behavior Disorders Behavior Modification Behavior Problems Behavior therapy. Cognitive therapy Behaviour disorders Biological and medical sciences Child Behavior Disorders - psychology Child Behavior Disorders - rehabilitation Clinical outcomes Cognitive Behavior Therapy Cognitive Restructuring Cognitive Therapy Comorbidity Comparative Analysis Competence Compliance (Psychology) Counseling Effectiveness Counseling Techniques Counselor Qualifications Drug Abuse Family Counseling Family psychotherapy. Systemic therapy Family Relationship Family Therapy Female Follow-Up Studies Human Humans Impact analysis Individual Psychotherapy Internal-External Control Interrater Reliability Male Marijuana Medical sciences Outcomes of Treatment Patient Compliance - psychology Predictor Variables Professional Competence Professional-Patient Relations Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Psychotherapies. Psychological and clinical counseling Studies Substance Abuse Substance-Related Disorders - psychology Substance-Related Disorders - rehabilitation Teenagers Therapists Therapy Treatment Compliance Treatments
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	This study examined the impact of treatment adherence and therapist competence on treatment outcome in a controlled trial of individual cognitive-behavioral therapy (CBT) and multidimensional family therapy (MDFT) for adolescent substance use and related behavior problems. Participants included 136 adolescents (62 CBT, 74 MDFT) assessed at intake, discharge, and 6-month follow-up. Observational ratings of adherence and competence were collected on early and later phases of treatment (192 CBT sessions, 245 MDFT sessions) by using a contextual measure of treatment fidelity. Adherence and competence effects were tested after controlling for therapeutic alliance. In CBT only, stronger adherence predicted greater declines in drug use (linear effect). In CBT and MDFT, (a) stronger adherence predicted greater reductions in externalizing behaviors (linear effect) and (b) intermediate levels of adherence predicted the largest declines in internalizing behaviors, with high and low adherence predicting smaller improvements (curvilinear effect). Therapist competence did not predict outcome and did not moderate adherence-outcome relations; however, competence findings are tentative due to relatively low interrater reliability for the competence ratings. Clinical and research implications for attending to both linear and curvilinear adherence effects in manualized treatments for behavior disorders are discussed.
ISSN:	0022-006X 1939-2117