Clinicians' fidelity to a manual-based family treatment as a predictor of the one-year course of bipolar disorder.

Abstract

This study assessed whether therapist adherence to the family focused treatment model for patients with bipolar disorder and their relatives was associated with patient outcomes at one year after treatment entry. A total of 78 videotaped sessions of FFT consisting of 26 families with a member with bipolar disorder (3 sessions/family) were rated on fidelity using the Therapist Competence/Adherence Scale (TCAS; see Endnote 1, p. 130). Patients' outcomes (relapse status) were assessed using the Brief Psychiatric Rating Scale (BPRS) and selected items from the Schedule of Affective Disorders and the Schizophrenia-Change (SADS-C) scale (measured at 3-month intervals for 12 months). Contrary to expectations, therapist fidelity was not related to overall outcome as assessed by the BPRS and the SADS-C. Among patients who did relapse, higher levels of cooperation among therapists predicted a later date for relapse than did lower levels of cooperation. Surprisingly, and in opposition to the study's hypotheses, patients who were hospitalized because of relapses had therapists who were rated as more competent in their ability to conduct the problem-solving module of FFT. Study implications are discussed.

• Authors: Amy Weisman, Martha C Tompson, Sumie Okazaki, Jennifer Gregory, Michael J Goldstein, Margaret Rea, David J Miklowitz
• Journal: Family process (Fam Process) Vol. 41 Issue 1 Pg. 123-31 ( 2002) ISSN: 0014-7370 [Print] United States
• PMID: 11924080 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Bipolar Disorder (psychology, therapy)
• Clinical Competence
• Family Therapy (methods, standards)
• Female
• Guideline Adherence
• Humans
• Los Angeles
• Male
• Middle Aged
• Problem Solving
• Psychiatric Status Rating Scales
• Treatment Outcome