Multiple-family group treatment reduced caregivers' distress but did not increase caregivers' resources relative to standard psychiatric care.

The findings support the adaptation of MFGT for brain and spinal cord injuries.

Multiple family group treatment (MFGT) is an evidence-based cognitive behavioral psycho-education and problem-solving intervention for the management of schizophrenia. Despite empirical support for the efficacy of MFGT, there is no psychometric tool for measuring treatment integrity in MFGT. In addition, research has not examined the impact of treatment integrity on client and family outcomes. The psychometric properties of a clinician integrity measure and its relationship to client and family outcomes was investigated among 7 clinician dyads who provided treatment to 53 persons with schizophrenia and their families over 2 years. The treatment integrity measure was found to have adequate psychometric properties and was able to differentiate clinicians with low, moderate, and high treatment integrity. To investigate the association of integrity with outcomes, dyads were split into low/moderate and high MFGT integrity groups. It was hypothesized that participants who received high integrity MFGT would experience a greater reduction in client psychiatric symptoms and more positive psychological health in family caregivers, relative to persons who received low/moderate integrity MFGT. Accounting for pre-intervention levels of psychiatric symptoms and session attendance, clients who were provided high integrity MFGT demonstrated significantly lower post-randomization scores on two measures of psychiatric symptoms, relative to those who received low/moderate integrity MFGT. There was no effect of treatment integrity on family caregiver outcomes. Discussion focuses on the issues associated with measuring and assuring treatment integrity in clinical research and practice.

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