Documents
Resources
Learning Center
Upload
Plans & pricing Sign in
Sign Out

An exploratory test of two solution focused therapy

VIEWS: 48 PAGES: 20

									An exploratory test of
two solution focused
therapy fidelity
instruments
            Peter Lehmann, PhD
            Randall Basham, PhD
            Emily Spence, PhD
            University of Texas at
            Arlington
Purpose

• Contribute towards the movement of SFT
  as an evidence-based model
• Test the reliability and validity of two SFT
  fidelity instruments
Solution Focused Therapy
• Brief, goal-directed therapeutic model (de
  Shazar, 1982, 1985, 1988)
• Strengths based
• Used for individual, couples, family & group
  treatment
• Our application of SFT is delivered mostly by
  Masters-level student interns in a university-
  based counseling center primarily serving youth
  and families referred by a school district
Intervention Fidelity

• The degree to which the delivery of an
  intervention adheres to the original model
  (Mowbray, Holter, Teague & Bybee, 2003)
• When combined with outcome evaluation,
  fidelity assessment becomes an
  instrumental part of determining whether or
  not an intervention is effective.
Research Design
• Time series design with assessments made
  during the 3rd session and every 3 sessions
  thereafter.
• Instruments:
   – Solution Focused Fidelity Instrument Therapist (SFT-
     FIT)
   – Solution Focused Fidelity Instrument Consumer (SFT-
     FIC)
• Assessed reliability (internal consistency) and
  factorial validity with 66 clients and 12 student
  therapists at the UTA Community Services
  Center
Instruments
• SFT FIC and FIT include 18 mirror items worded for the
  respondent
• Items are measured on a scale of 1 (Not at all) to 7 (Very
  clearly and specifically)
• The first 17 items assess fidelity and the last item refers to
  consistency with previous sessions
• The FIT is in it’s 8th version and the FIC in it’s 3rd version
• Face and content validity was promoted via the review
  and revision of the instruments collaboratively with ~20
  SFT experts on an international SFT listserv
Sample

• N=169 SFT-FIT’s and FIC’s
• Valid Cases: N=160 (excludes missing
  data)
• 70 FIT’s completed by 11 student interns
  and 1 therapist
• 99 FIC’s completed by 66 clients
Respondent Demographics
• Therapists                  • Consumers
   – 11 Masters Social Work      – 32 Clients seen individually
     interns                     – 34 seen in family sessions
   – 1 Licensed Therapist     • Age
   – 3 Males, 9 Females
                                 – 44.4% 17 years or under
   – Age
                                 – 31.2% 18-35 years
       • 7 18-35 years old
                                 – 24.6% over 35 years
       • 5 over 35 years
   – Ethnicity                • Ethnicity
       • 6 Caucasian-Anglo       –   51.2% African-decent
       • 3 African-decent        –   27.9% Hispanic
       • 1 Asian                 –   14% Caucasian/Anglo
                                 –   7% Asian
Results: Reliability

• Overall internal consistency for combined
  FIT and FIC instruments was alpha=.89
• Overall scale mean= 96.78 (SD=17.36;
  possible range is 18-126)
• First administration alpha=.88
• Differences observed between the FIT and
  FIC’s
Internal Consistency
• FIT                       • FIC
  –   Alpha=.76               –   Alpha=.93
  –   Scale mean=91.50        –   Scale Mean=100.79
  –   Standard Dev=12.49      –   Standard Dev=19.42
  –   Mean of items: 5.08     –   Mean of items:5.60
Factorial Validity
• Principal component analysis used to determine
  the least number of factors that can account for
  common variance among items
• Factors extracted using Varimax rotation with
  Kaiser Normalization
• Eigenvalues set at 1.00
• KMO measure of sampling adequacy: .90 for FIC
  & .721 for FIT
• Bartlett's Test of Sphericity: p=.000 for both;
  reject null hypothesis of identity matrix
Factor Analysis Combined
FIT & FIC
• Total Explained variance = 52.43%
• Items are inter-correlated and represent a
  one-dimensional scale
• Psychometric properties of SFT depend on
  summative item contributions- thus
  individual item analysis not recommended
SFT-FIC Factor Analysis
• 3
  components
  with
  eigenvalues
  greater than
  zero which
  explain
  65.68% of
  the variance
FIC Factor Analysis
• Component One:
  – Explains 52.4% of variance
  – Loads 15 items (majority of scale)
• Component Two
  – Explains 7.4% of variance
  – Loads one item (rating scale)
• Component Three
  – Explains 5.89% of variance
  – Loads two items (miracle question and homework)
FIT Factor Analysis
• 5
  components
  with
  eigenvalues
  greater than
  1 explain
  57.8% of
  variance
FIT Factor Analysis
• Component One:
  – Explains 24.9% of variance & loads 9 items (mostly solution talk
    oriented)
• Component Two:
  – Explains 10.5% of variance & loads 3 items (homework,
    compliments, ID of what’s better)
• Component Three:
  – Explains 9.8% of variance & loads two items (rating scale and
    miracle questions)
• Component Four:
  – Explains 6.8% of variance & loads one item (goal-related)
• Component Five:
  – Explains 5.8% of variance & loads 1 item (coping questions)
Limitations/Implications
• Small sample size warrant further testing to
  assess for similar factorial patterns
• Need to consider wording of task-related model
  components that may not occur every session
• Need further examination with larger sample of
  FIT variability & strengthen research design with:
  – comparison to professional sample
  – comparison to video-taped sessions, or two-way mirror
    observation sessions
• Next stage of development is to combine with
  outcome evaluation and use in different treatment
  contexts/venues
References
•   de Shazar, S. (1982). Patterns of brief family therapy. New York: Guilford.
•   de Shazar, S. (1985). Keys to solution in brief therapy. New York: W.W. Norton.
•   de Shazar, S. (1988). Clues: Investigating solutions in brief therapy. New York: W.W.
         Norton.
•   de Shazar, D., Berg, I. K., Lipchik, E., Nunnally, E., Molnar, A., Gingerich, W., &
         Weiner-Davis, M. (1986). Brief therapy: Focused Solution Development. Family
         Process, 25, 207-221.
•   Gingerich, W.J., & Eisengart, S. (2000). Solution-focused brief therapy: A review of
         the outcome research. Family Process, 29, 477-498.
•   Mowbray, C. T., Holter, M. C., Teague, G. B., & Bybee, D. (2003). Fidelity criteria:
         Development, measurement, and validation. American Journal of Evaluation, 24,
         315-340.
•   Trepper, T. S., Dolan, Y., McCollum, E. E., & Nelson, T. (2006). Steve de Shazar and
         the future of solution-focused therapy. Journal of Marital & Family Therapy, 32,
         133-140.

								
To top