Family therapy treatment adherence among community-based health center family therapists working with adolescents

Emalinda Leilani McSpadden, Fordham University


The purpose of this study was to examine the correspondence of therapists' self-report treatment adherence ratings (reflecting adherence) to trained observers' ratings of core interventions of Family Therapy. Ratings were collected using a new measure, the Inventory of Therapeutic Techniques (ITT), and this study aimed to explore initial performance of the instrument on a pilot data set. This study focused on therapists working with adolescents having substance use and/or externalizing problems, and their families, within a community-based mental health center that features Family Therapy as the routine standard of care. This was also a pilot study for a larger research project examining Family Therapy and its effectiveness with this population of adolescents. The participants in this study included 16 adolescent clients (9 female and 7 male) and their families, 7 therapists (4 female and 3 male), and 2 trained observers (1 female and 1 male). Two of the hypotheses were supported (therapists' rating their own adherence to Family Therapy techniques higher than observer ratings, and therapists rating Family Therapy items more reliably than Cognitive Behavioral Therapy, Motivational Interviewing, or Drug Counseling items), while the other two hypotheses were only partially supported (therapists and coders rating Family Therapy items on the ITT higher and more frequently than items from other subscales, and variance in scores within subscales being more attributable to clients than therapists). Results indicated that Therapists and observers had the lowest mean difference between their scores on items from the Family Therapy subscale, that therapists rated themselves most reliably on Family Therapy subscale items, and that variance among therapists' scores were more attributable to what client was being treated rather than who the treating therapist was. Implications for future research include maintenance and refinement of therapist preparation on the ITT for use in the parent research project, client perspectives on what therapists are doing in sessions, and establishing predictive validity beyond the constraints of this research design.

Subject Area

Counseling Psychology|Developmental psychology

Recommended Citation

McSpadden, Emalinda Leilani, "Family therapy treatment adherence among community-based health center family therapists working with adolescents" (2012). ETD Collection for Fordham University. AAI3542751.