Abstract
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.
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.
- Content Type Journal Article
- Category Original Paper
- Pages 1-15
- DOI 10.1007/s10826-012-9638-5
- Authors
- Stacy R. Ryan, Center for Addiction Reserach, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
- Phillippe B. Cunningham, Family Research Center, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA
- Sharon L. Foster, Department of Psychology, Alliant International University at San Diego, San Diego, CA, USA
- Patricia A. Brennan, Department of Psychology, Emory University, Atlanta, GA, USA
- Rebecca L. Brock, Department of Psychology, The University of Iowa, Iowa City, IA, USA
- Elizabeth Whitmore, Department of Psychiatry, University of Colorado at Denver, Denver, CO, USA
- Journal Journal of Child and Family Studies
- Online ISSN 1573-2843
- Print ISSN 1062-1024