The DOI matches its Crossref record; 67 of the 69 references it cites were found in a registry or an index.
Treatment adherence, competence, and outcome in individual and family therapy for adolescent behavior problems
Open accessAbstract
This study examined the impact of treatment adherence and therapist competence on treatment outcome in a controlled trial of individual cognitive-behavioral therapy (CBT) and multidimensional family therapy (MDFT) for adolescent substance use and related behavior problems. Participants included 136 adolescents (62 CBT, 74 MDFT) assessed at intake, discharge, and 6-month follow-up. Observational ratings of adherence and competence were collected on early and later phases of treatment (192 CBT sessions, 245 MDFT sessions) by using a contextual measure of treatment fidelity. Adherence and competence effects were tested after controlling for therapeutic alliance. In CBT only, stronger adherence predicted greater declines in drug use (linear effect). In CBT and MDFT, (a) stronger adherence predicted greater reductions in externalizing behaviors (linear effect) and (b) intermediate levels of adherence predicted the largest declines in internalizing behaviors, with high and low adherence predicting smaller improvements (curvilinear effect). Therapist competence did not predict outcome and did not moderate adherence-outcome relations; however, competence findings are tentative due to relatively low interrater reliability for the competence ratings. Clinical and research implications for attending to both linear and curvilinear adherence effects in manualized treatments for behavior disorders are discussed.
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“As per the study team’s numerous observational fidelity studies [126-130], 1 session will be randomly selected from the early phase of treatment (sessions 1 to 3) and 2 from the later phase (sessions from session 5) of each client for coding with an observational version of the Fam-AID Fidelity Checklist (described in the Study Measures section).”
From Family Support Protocol for Adolescent Internalizing Disorders: Protocol for a Pre-Post Quantitative Treatment Development Study (2024) · cites this paper as [130]
Experimental — accuracy not yet measuredIn the citing paper
“Therapist adherence level is a better predictor of positive therapy outcomes than competence per se (e.g., Hogue et al., 2008).”
From Therapist drift redux: Why well-meaning clinicians fail to deliver evidence-based therapy, and how to get back on track (2016) · cites this paper as Hogue et al., 2008
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Cites
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“Cohens’ d effect size for this association (van Lier, Muthe´n, van der Sar, & Crijnen, 2004) was .44; according to Cohen (1988) , d .20 is a small effect, .50 is medium, and .80 large.”
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“Both the CBT and MDFT items demonstrated good-to-excellent interrater reliability for adherence but only fair-to-poor reliability for competence as measured by the intraclass correlation coefficient (ICC[1,2]; Shrout & Fleiss, 1979 ).”
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Schafer, J. L., & Graham, J. W. (2002) · Psychological Methods · doi:10.1037/1082-989x.7.2.147 · Cited by 11,638 · cited 2×
“Missing data were addressed with full information maximum likelihood estimation, which produces unbiased parameter estimates under the assumption that data are missing at random (Schafer & Graham, 2002).”
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“For this subgroup, the featured elements of manualized treatments designed to target drug use and externalizing behaviors specifically may need to be moderated in favor of auxiliary interventions that directly target internalizing problems: changing unrealistic negative thoughts, interpersonal problem-solving skills,…”
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“Another study limitation is that a full examination of treatment dropout effects on fidelity–outcome relations (see Hedeker & Gibbons, 1997) was beyond the scope of this study.”
Cited by
Sorted by citations
Implementation fidelity in community‐based interventions
Breitenstein, S. M., Gross, D. A., Garvey, C., Hill, C., Fogg, L., & Resnick, B. M. (2010) · Research in Nursing & Health · doi:10.1002/nur.20373 · Cited by 717
“For example, Hogue et al. (2008) found no relationship between competence and intervention outcomes.”
BackgroundResultInfluentialTherapist adherence/competence and treatment outcome: A meta-analytic review.
Webb, C. A., DeRubeis, R. J., & Barber, J. P. (2010) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0018912 · Cited by 657
“Furthermore, findings from a few of the studies reviewed (e.g., Barber et al, 2006, 2008; Hogue et al., 2008; Piper et al., 1991) suggest that, at least in some contexts, the relation between adherence or competence and outcome may be nonlinear (e.g., quadratic).”
BackgroundMcHugh, R. K., Murray, H. W., & Barlow, D. H. (2009) · Behaviour Research and Therapy · doi:10.1016/j.brat.2009.07.005 · Cited by 320
“Moreover, conceptualizations of fidelity vary in the role of clinician competence, with some suggesting that it is a component of fidelity (e.g., Hogue et al., 2008) and others suggesting that it may reflect a related but distinct construct (e.g., Barber, Sharpless, Klosterman, & McCarthy, 2007).”
BackgroundFamily therapy for drug abuse: Review and updates 2003-2010
Rowe, C. L. (2012) · Journal of Marital and Family Therapy · doi:10.1111/j.1752-0606.2011.00280.x · Cited by 294
Waller, G., & Turner, H. (2016) · Behaviour Research and Therapy · doi:10.1016/j.brat.2015.12.005 · Cited by 256
Metadata
- Authors
- Hogue, A., Henderson, C. E., Dauber, S., Barajas, P. C., Fried, A., & Liddle, H. A.
- Affiliations
- National Center on Addiction and Substance Abuse at Columbia University (US)
- Sam Houston State University (US)
- University of Miami (US)
- Corresponding author
- Hogue, Aaron
- Venue
- Journal of Consulting and Clinical Psychology
- Published
- 2008-08
- Volume
- 76
- Issue
- 4
- Pages
- 544-555
- ISSN
- 0022-006X (ISSN-L)
- 1939-2117
- PMC
- PMC2843085
- OpenAlex
- W2155455205
- Cited by
- 284
- References
- 69
- Citations by year
- 2026: 3 · 2025: 17 · 2024: 13 · 2023: 7 · 2022: 12 · 2021: 24 · 2020: 8 · 2019: 18 · 2018: 18 · 2017: 16 · 2016: 13 · 2015: 20 · 2014: 25 · 2013: 29 · 2012: 30
- FWCI
- 11.53
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Consulting and Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Drug Abuse (R01 DA14571; P50 DA07697)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Clinical Psychology › Counseling, Therapy, and Family Dynamics
- Keywords
- medication adherence, therapist competence, treatment outcomes, adolescent substance use, adolescent behavior problems, cognitive behavioral therapy, multidimensional family therapy, intervention fidelity, therapeutic relationship, externalizing problems, internalizing problems
- MeSH terms
- Adolescent, Child Behavior Disorders, Family Therapy, Female, Follow-Up Studies, Humans, Internal-External Control, Male, Patient Compliance, Professional Competence, Professional-Patient Relations, Comorbidity, Cognitive Behavioral Therapy, Substance-Related Disorders
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