Predictors of Therapist Adherence and Emotional Bond in Multisystemic Therapy: Testing Ethnicity as a Moderator.

Predictors of Therapist Adherence and Emotional Bond in Multisystemic Therapy: Testing Ethnicity as a Moderator.
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DOI:
10.1007/s10826-012-9638-5
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发表时间:
2013-01-01
影响因子:
2.1
通讯作者:
Whitmore, Elizabeth
Whitmore, Elizabeth
中科院分区:
心理学3区
文献类型:
--
作者:
Ryan, Stacy R.;Cunningham, Phillippe B.;Foster, Sharon L.;Brennan, Patricia A.;Brock, Rebecca L.;Whitmore, Elizabeth

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本研究探讨了问题严重程度和种族之间的相互作用,作为治疗师依从性和家庭治疗师情感纽带的预测。本研究的数据来自于社区环境中许可的MST提供者组织提供的多系统治疗(MST)的纵向评估。结果变量包括中等治疗水平的照顾者报告的治疗师的坚持,治疗过程中的治疗师的坚持照顾者报告的变化,和整体水平的治疗师和青年治疗师的情感纽带。假设的预测因素包括种族、民族和多种物质使用水平、外化行为、青少年在治疗早期的犯罪自我报告以及治疗前的逮捕次数。研究对象为185名青少年(M年龄= 15.35,SD = 1.29)及其照顾者。在参与调查的年轻人中,48%的人自认为是高加索人,20%的人是非洲裔美国人,28%的人是西班牙裔/拉丁裔,4%的人是“其他”。两级分层线性模型分析显示,对于白人青年,自我报告的犯罪率较低,与照顾者报告的治疗师坚持在MST的过程中更大的增加。对于西班牙裔\拉丁裔照顾者,较高的外化行为和多种物质的使用与治疗中期较低的治疗依从性和与治疗师的整体情感联系水平较差的报告相关。相比之下,对于非洲裔美国人的参与者,较高水平的青年外化行为和多种物质的使用与较高的整体水平的照顾者和青年报告的情感纽带与治疗师,分别。结果提供的证据表明,种族\民族与问题的严重程度在预测治疗师的依从性和家庭治疗师的情感纽带在现实世界的实践设置,并建议可能的治疗过程中的种族差异。
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 His-panic\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.
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