TY - JOUR
T1 - Predictors of Therapist Adherence and Emotional Bond in Multisystemic Therapy
T2 - Testing Ethnicity as a Moderator
AU - Ryan, Stacy R.
AU - Cunningham, Phillippe B.
AU - Foster, Sharon L.
AU - Brennan, Patricia A.
AU - Brock, Rebecca L.
AU - Whitmore, Elizabeth
N1 - Funding Information:
Acknowledgments The second author is a paid consultant of MST Services and is part owner of Evidence Based Services, Inc., a MST Network Partner Organization. Preparation of this article was funded in part by grant R01MH068813 from the National Institute of Mental Health. The authors are grateful to Angi Wold and the research assistants who collected the data. Steve Shapiro provided data management.
PY - 2013/1
Y1 - 2013/1
N2 - This study examined the interaction between problem severity and race\ethnicity as a predictor of therapist adherence and family-therapist emotional bond. Data for this study came from a longitudinal evaluation of Multisystemic Therapy (MST) provided by licensed MST provider organizations in community settings. Outcome variables included mid-treatment levels of caregiver report of therapist adherence, changes in caregiver report of therapist adherence over the course of treatment, and overall levels of caregiver-therapist and youth-therapist emotional bond. Hypothesized predictors included race\ethnicity and levels of poly-substance use, externalizing behavior, and youth self-report of delinquency early in treatment as well as pre-treatment number of arrests. Participants were 185 adolescents (M age = 15. 35, SD = 1. 29) and their caregivers. Of the participating youth, 48 % self-identified as Caucasian, 20 % as African-American, 28 % as Hispanic\Latino, and 4 % as "other." Two-level Hierarchical Linear Modeling analyses revealed that for Caucasian youth, lower rates of self-reported delinquency were associated with greater increases in caregiver report of therapist adherence over the course of MST. For Hispanic\Latino caregivers, higher externalizing behavior and poly-substance use were associated with reports of lower therapist adherence at mid-treatment and poorer overall levels of emotional bonding with therapists. In contrast, for African-American participants, higher levels of youth externalizing behavior and poly-substance use were associated with higher overall levels of caregiver and youth report of emotional bonding with therapists, respectively. Results provide evidence that race\ethnicity interacts with problem severity in predicting therapist adherence and family-therapist emotional bond within real-world practice settings and suggest possible therapeutic process differences across race.
AB - This study examined the interaction between problem severity and race\ethnicity as a predictor of therapist adherence and family-therapist emotional bond. Data for this study came from a longitudinal evaluation of Multisystemic Therapy (MST) provided by licensed MST provider organizations in community settings. Outcome variables included mid-treatment levels of caregiver report of therapist adherence, changes in caregiver report of therapist adherence over the course of treatment, and overall levels of caregiver-therapist and youth-therapist emotional bond. Hypothesized predictors included race\ethnicity and levels of poly-substance use, externalizing behavior, and youth self-report of delinquency early in treatment as well as pre-treatment number of arrests. Participants were 185 adolescents (M age = 15. 35, SD = 1. 29) and their caregivers. Of the participating youth, 48 % self-identified as Caucasian, 20 % as African-American, 28 % as Hispanic\Latino, and 4 % as "other." Two-level Hierarchical Linear Modeling analyses revealed that for Caucasian youth, lower rates of self-reported delinquency were associated with greater increases in caregiver report of therapist adherence over the course of MST. For Hispanic\Latino caregivers, higher externalizing behavior and poly-substance use were associated with reports of lower therapist adherence at mid-treatment and poorer overall levels of emotional bonding with therapists. In contrast, for African-American participants, higher levels of youth externalizing behavior and poly-substance use were associated with higher overall levels of caregiver and youth report of emotional bonding with therapists, respectively. Results provide evidence that race\ethnicity interacts with problem severity in predicting therapist adherence and family-therapist emotional bond within real-world practice settings and suggest possible therapeutic process differences across race.
KW - Ethnic difference
KW - Externalizing behavior
KW - Minority
KW - Multisystemic therapy
KW - Therapist adherence
KW - Treatment
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U2 - 10.1007/s10826-012-9638-5
DO - 10.1007/s10826-012-9638-5
M3 - Article
AN - SCOPUS:84871648481
VL - 22
SP - 122
EP - 136
JO - Journal of Child and Family Studies
JF - Journal of Child and Family Studies
SN - 1062-1024
IS - 1
ER -