How to Coach Yourself and Others Coaching Families | Page 80
Conduct Disorder.
Analyses of variance indicated that conduct disorder scores for adolescents in BSFT compared to those for
adolescents in group counseling were significantly reduced between pre- and posttreatment. In the clinical
significance analyses, a substantially larger proportion of adolescents in BSFT than in group counseling
demonstrated clinically significant improvement. At intake, 70 percent of adolescents in BSFT had conduct
disorder scores that were above clinical cutoffs. That is, they scored above the empirically established
threshold for clinical diagnoses of conduct disorder. At the end of treatment, 46 percent of these adolescents
showed reliable improvement, and 5 percent showed reliable deterioration. Among the 46 percent who
showed reliable improvement, 59 percent recovered to nonclinical levels of conduct disorder. In contrast, at
intake, 64 percent of adolescents in group counseling had conduct disorder scores above the clinical cutoff.
Of these, none showed reliable improvement, and 11 percent showed reliable deterioration. Therefore, while
adolescents in BSFT who entered treatment at clinical levels of conduct disorder had a 66 percent likelihood
of improving, none of the adolescents in group counseling re liably improved.
Association With Antisocial Peers.
Analyses of variance indicated that, for adolescents in BSFT, scores for association with antisocial peers
were significantly reduced between pre- and post-treatment, compared to those for adolescents in group
counseling. In the clinical significance analyses, 79 percent of adolescents in BSFT were above clinical
cutoffs for association with antisocial peers at intake. Among adolescents in BSFT meeting clinical criteria
for association with antisocial peers, 36 percent showed reliable improvement, and 2 percent showed
reliable deterioration. Of the 36 percent of adolescents in BSFT with reliable improvement, 50 percent were
classified as recovered. Among adolescents in group counseling, 64 percent were above clinical cutoffs for
association with antisocial peers at intake. Among adolescents in group counseling meeting these clinical
criteria at intake, 11 percent reliably improved, and none reliably deteriorated. Of the 11 percent of
adolescents in group counseling evidencing reliable improvement in association with antisocial peers, 50
percent recovered to nonclinical levels. Hence, adolescents in BSFT who entered treatment at clinical levels
of association with antisocial peers were 2.5 times more likely to reliable improve than were adolescents in
group treatment. Marijuana Use. Analyses of variance revealed that BSFT was associated with significantly
greater reductions in self-reported marijuana use than was group counseling. To investigate whether
clinically meaningful 3 changes in marijuana use occurred, four use categories from the substance use
literature (e.g., Brooks et al.1998) were employed.
These categories are based on the number of days an individual uses marijuana in the 30 days before the
intake and termination assessments:
abstainer - 0 days
weekly user - 1 to 8 days
frequent user - 9 to 16 days
daily user - 17 or more days
In BSFT, 40 percent of participants reported using marijuana at intake and/or termination. Of these, 25
percent did not show change, 60 percent showed improvement in drug use, and 15 percent showed
deterioration. Of the individuals in BSFT who shifted into less severe categories, 75 percent were no longer
using marijuana at termination. In group counseling, 26 percent of participants reported using marijuana at
intake and/or termination. Of these, 33 percent showed no change, 17 percent showed improvement, and 50
percent deteriorated. The 17 percent of adolescents in group counseling cases that showed improvement
were no longer using marijuana at termination. Hence, adolescents in BSFT were 3.5 times more likely than
were adolescents in group counseling to show improvement in marijuana use.
Treatments also were compared in terms of their influence on family functioning. Family functioning was
measured using the Structural Family Systems Ratings (Szapocznik et al. 1991). This measure was
constructed to assess family functioning as defined in Chapter 3. Based on their scores when they entered
therapy, families were separated by a median split into those who had good and those who had poor family
functioning. Within each group (i.e., those with good and those with poor family functioning), a statistical
test that compares group means (analysis of variance) tested changes in family functioning from before to
after the intervention.
80