Client Characteristics and Therapist Competence and Adherence to Family Therapy for Schizophrenia

by Dunham, Radha Gaia

The current study aims to clarify how therapist competence/adherence relates to client characteristics, consumer satisfaction, and dropout rates for family interventions for schizophrenia. The study was conducted as part of a larger treatment trial which will test the efficacy of a culturally informed therapy for schizophrenia (CIT-S), against a treatment as usual (TAU) comparison group. Encouragingly, overall, therapists were found to demonstrate very high levels of competence/adherence in both treatment conditions. As hypothesized, less severe psychiatric symptoms and lower ratings of family difficulty were related to greater therapist competence/ adherence in several non-specific (e.g., establishing rapport) and CIT-S specific (fostering family cohesion) domains of treatment. Also as hypothesized, certain aspects of greater competence/ adherence were related to lower dropout rates and higher consumer satisfaction. Contrary to expectations, general emotional distress and family cohesion were not related to competence/adherence. This study suggests that clinicians and clinical researchers may want to take certain client characteristics into account when evaluating therapist performance, choosing clients who are most suitable for therapy, and providing feedback to supervisees. Additionally, clinicians and researchers may want to monitor therapist performance early on in treatment in order to address issues which may impact consumer satisfaction and treatment retention.