A family therapy outcome study in an impatient setting



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The present study was a psychotherapy outcome project designed to evaluate the potential efficacy and effects of treating adolescents hospitalized on a short-term basis with family therapy against those treated with individual therapy. The subjects consisted of 28 adolescents and their families, with all adolescents hospitalized on the inpatient service of the Texas Research Institute of Mental Sciences. The subjects ranged in age from 13-21 years cf age. The subjects and their families were randomly assigned, to two treatment conditions, either family therapy (experimental) or individual therapy (control). The experimental adolescents and their families received ten sessions of family therapy and the control adolescents received ten sessions of individual therapy. Two therapy teams were utilized to treat the families in the experimental condition, each consisting of a male/female co-therapist dyad. The two teams each treated 7 families. The males from each cotherapy team each treated 7 adolescenty in individual therapy. The study utilized a 2x2x3 factorial design, with therapists and subjects vested within treatment conditions, and repeated measures given pre-treatment, post-treatment, and at three month follow-up. The data was analyzed by analysis of variance in the 2x2x3 factorial which tested the main and interaction effects of time, therapy (modality) and therapist. The two major hypotheses of the study concerning community adjustment of the adolescent subjects were both confirmed, with the significance level set at .05 using a two tailed test. The experimental adolescents showed a significantly lower rate of rehospitalization at three months post discharge than did the control adolescents. The experimental adolescents returned to functioning twice as fast as the control adolescents. Both findings taken together showed the adolescents who underwent family therapy to not only remain hospital free, but to also he functional in work or school while in the coirmunity. The ten minor hypotheses concerning changes in family members subjective perceptions of family behavior, and changes in families' verbal and nonverbal behaviors during a problem-solving task (rated objectively) showed largely insignificant results, with some noteable exceptions. Mothers who underwent family therapy Increased significantly in negative verbal behaviors over mothers who experienced no direct therapy. This same effect proved significant for fathers across both therapy conditions. Significantly increasal negative nonverbal behavior for father was therapist dependent. For adolescents, the only significant behavioral change recorded objectively was a significant decrease of positive nonverbal behavior across both therapy conditions. Mothers and adolescents showed significant changes in subjective perceptions, with adolescents indicating a perception that parent-adolescent communication was improved by family therapy in relation to adolescents who did not undergo family therapy. The mothers indicated that they viewed themselves as being more realistically perceived by their spouses in terms of their internal emotional states after undergoing family therapy in relation to mothers who received no direct therapy. The study indicated, in an overall sense, that community adaptation and a reduction of hospital recidivism can be greatly enhanced by use of family therapy with inpatient adolescents. The study also indicated that the internal processes within the family system leading to these desirable outcomes are not clearly defined and require extensive future work.