Year: 2004
Type: dissertation
Abstract: The relationship between in-session therapist integrity to multiple family group treatment (MFGT) and client outcomes (i.e., positive and negative symptoms, outpatient and inpatient psychiatric utilization) was investigated in 106 outpatients with schizophrenia.The Multiple Family Group Treatment Adherence and Competence Checklist (MFG-ACC) was developed as a rating of therapist integrity to the treatment model.A total of 42 treatment sessions were rated across 7 dyads of MFGT clinicians.Three MFG-ACC raters demonstrated adequate inter-rater reliability and agreement.The MFG-ACC also demonstrated adequate internal consistency and was able to discriminate between the 7 MFGT clinician dyads.Based upon clinicians' MFG-ACC scores the 55 participants randomized to MFGT were categorized into two groups: those who received moderate or high integrity MFGT.The effects of therapist integrity on client outcomes was investigated in the 55 participants who received MFGT and the entire sample (n = 106), including those who received standard psychiatric care (n = 51).Accounting for client difficulty and attendance among the 55 persons receiving MFGT, treatment integrity had a significant effect on negative symptoms, with clients who received higher integrity demonstrating lower negative symptoms, relative to those who received moderate integrity MFGT.The main effect of treatment integrity was not observed across other outcomes among the 55 and 106 participant samples.However across outcome variables, including negative v symptoms, evidence for the interaction between client difficulty and therapist integrity was observed.Among clients who were most difficult at randomization, high therapist integrity was associated with significantly improved outcomes.However, among low difficulty clients, moderate therapist integr ity was associated with improved client outcomes, relative to those receiving high integrity MFGT.Results suggest that MFGT may be most effective for high difficulty clients and that it may not be as helpful for those with low levels of psychiatric symptoms and service utilization.Results also provide evidence for the link between treatment integrity and client outcomes and suggest that future research focus on investigating the interaction between treatment integrity and client difficulty in larger samples and other therapeutic approaches.
Author: Michael G. McDonell
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W1482412781