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Clinicians' Fidelity to a Manual‐Based Family Treatment as a Predictor of the One‐Year Course of Bipolar Disorder
Author(s) -
Weisman Amy,
Tompson Martha C.,
Okazaki Sumie,
Gregory Jennifer,
Goldstein Michael J.,
Rea Margaret,
Miklowitz David J.
Publication year - 2002
Publication title -
family process
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.011
H-Index - 74
eISSN - 1545-5300
pISSN - 0014-7370
DOI - 10.1111/j.1545-5300.2002.40102000123.x
Subject(s) - psychology , brief psychiatric rating scale , rating scale , clinical psychology , bipolar disorder , fidelity , psychiatry , competence (human resources) , cognition , psychosis , developmental psychology , social psychology , electrical engineering , engineering
This study assessed whether therapist adherence to the family focused treatment model1 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.