Abstract
Treatment adherence and differentiation in dynamic
cognitive-behavioral therapy and multidimensional family therapy for
adolescent substance abuse were evaluated with a treatment adherence
process measure. Full-length videotapes of 90 treatment sessions (36
clients) were reviewed by nonparticipant raters. Adherence scales
for each treatment generated through factor analysis of
observational ratings demonstrated sound interrater reliability and
internal consistency. Therapists in each condition used techniques
unique to their own model and avoided those unique to the competing
model. Individual therapists emphasized behavioral and substance-use
interventions, whereas family therapists focused on interactional
and affective interventions. Challenges in conducting adherence
research that compares individual and family treatments are
addressed, as are implications of these results for advancing
treatment development for adolescent drug users.
