Ag. Weisman et al., EVALUATING THERAPIST COMPETENCE AND ADHERENCE TO BEHAVIORAL FAMILY MANAGEMENT WITH BIPOLAR PATIENTS, Family process, 37(1), 1998, pp. 107-121
The present study assessed fidelity to the behavioral family managemen
t(BFM) model for treating bipolar disorder patients and their families
. The BFM Therapist Competency/Adherence Scale (BFM-TCAS) was develope
d to evaluate clinicians' competency and adherence to BFM, as outlined
by Miklowitz' (1989) BFM Manual for use with bipolar patients. Therap
ist competency and treatment adherence was also evaluated with regard
to two family characteristics: overall level of family difficulty and
family expressed emotion (EE) status. The BFM-TCAS was used to code 78
videotaped sessions of 26 families with a bipolar member, selected fr
om a larger treatment study of bipolar disorder patients. The findings
suggest that, overall, clinicians adhered closely to the BFM manual.
Specific areas in which there was high competency and treatment adhere
nce were (a) skill in conveying factual information about bipolar illn
ess, (b) establishment of a therapeutic environment, and (c) ability t
o take command of therapy sessions. The one area in which there was le
ss compotency and relatively weak adherence to the manual was the use
of between-session homework assignments to assist families in masterin
g the BFM exercises. Results of this study also suggest that, for the
most part, therapist competency and adherence ratings were not related
to overall level of difficulty or to family EE status.