A Preliminary Investigation of Ethnic Differences in Resistance in Multisystemic Therapy

Caitlin S. Sayegh, Brittany N. Hall-Clark, Dawn D. McDaniel, Colleen A. Halliday-Boykins, Phillippe B. Cunningham, Stanley J. Huey

Research output: Contribution to journalArticle

Abstract

Therapy process research suggests that an inverted U-shaped trajectory of client resistance, referred to as the struggle-and-working-through pattern, predicts positive treatment outcomes. However, this research may lack external validity given the exclusive focus on European Americans. This preliminary study explores differences in resistance patterns in a sample of African American and European American juvenile drug offenders and their families (n = 41) participating in Multisystemic Therapy. Resistance was coded from session recordings at the beginning, middle, and end of treatment. There were significant ethnic differences in (a) mean resistance at midtreatment, (b) resistance trajectories, and (c) predictive relationships between resistance trajectories and criminal desistance. Notably, a negative quadratic (i.e., inverted U-shaped) resistance trajectory was more characteristic of European Americans who desisted from crime, whereas a positive quadratic (U-shaped) resistance pattern was more characteristic of African Americans who desisted. There was no relationship between resistance trajectory and later drug abstinence (i.e., cannabis). Within the context of evidence-based therapies, core treatment processes may vary significantly as a function of client ethnicity. We recommend that clinical scientists make efforts to test for ethnic differences in treatment process so that therapies like Multisystemic Therapy can be understood in a more comprehensive and nuanced manner.

Original languageEnglish (US)
Pages (from-to)S13-S23
JournalJournal of Clinical Child and Adolescent Psychology
Volume48
Issue numbersup1
DOIs
StatePublished - Mar 29 2019

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Clinical Psychology

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