Does the STIC measurement and feedback system improve multisystemic outcomes in individual, couple and family therapy? A randomized clinical trial.

OBJECTIVE: In a randomized clinical trial, we evaluated whether the STIC (Systemic Therapy Inventory of Change) measurement and feedback system (MFS), the first MFS to explicitly integrate the family systems perspective, improved outcomes in individual, couple and family therapy. METHOD: Nine hundred and seventy clients seeking individual, couple or family therapy, entered therapy with 93 therapists at four sites in the Chicago metropolitan area. All therapists were trained with the STIC and participated in both Treatment as Usual (TAU) and TAU with the STIC (STIC). After agreeing to participate, clients were randomly assigned to TAU or STIC. Therapists did not know the condition to which a case was assigned, until just prior to the first session. Therapy was not time-limited or constrained, except for the use of the STIC in the STIC condition. All clients were evaluated on a non-STIC multi-systemic battery of widely used outcome measures pre-and-post therapy. RESULTS: STIC clients improved more than TAU clients regardless of treatment modality or outcome measure. Clinically significant change was also greater for STIC than TAU clients across outcome measures. CONCLUSION: The STIC MFS holds promise for improving outcomes beyond TAU in individual, couple, and family therapy.

Testing the convergent and discriminant validity of the Systemic Therapy Inventory of Change Initial scales.

OBJECTIVE: The Systemic Therapy Inventory of Change (STIC®) is the first multi-systemic and multi-dimensional measurement and feedback system designed for assessment in family, couple, and individual functioning. Patients fill out the STIC Initial before the first session to identify treatment targets and provide starting values for subsequent assessments of trajectories of change. This study tested the construct validity of five of the six STIC Initial scales. METHODS: We administered both the STIC Initial and a set of validity measures to a relatively large sample of patients. Convergent and discriminant validity were tested using both an examination of observed correlations and confirmatory factor analysis (CFA). RESULTS: The correlations among the observed measures showed that the convergent validity coefficients were generally large, whereas the discriminant validity coefficients were moderate to small. Similarly, CFAs suggested that the STIC total scales and subscales are good indicators of the factors they were intended to measure and that the STIC total scales and subscales are weakly related to the factors they were intended to not measure. CONCLUSION: The results supported the convergent and discriminant validity of the five scales of the STIC Initial. Clinical or methodological significance of this article: The clinical significance of this article is that it demonstrates that the STIC Initial should be useful for identifying treatment targets including both which systems, in addition to the facets within each system, that require targeting. The methodological significance is twofold. First, the use of CFA for testing convergent and discriminant validity is still relatively rare. Second, we demonstrated how to use CFA for a more stringent test of discriminant validity compared with the original approach described by Cole ( 1987 ).

Confirming, Validating, and Norming the Factor Structure of Systemic Therapy Inventory of Change Initial and Intersession.

UNLABELLED: Progress or feedback research tracks and feeds back client progress data throughout the course of psychotherapy. In the effort to empirically ground psychotherapeutic practice, feedback research is both a complement and alternative to empirically supported manualized treatments. Evidence suggests that tracking and feeding back progress data with individual or nonsystemic feedback systems improves outcomes in individual and couple therapy. The research reported in this article pertains to the STIC(®) (Systemic Therapy Inventory of Change)-the first client-report feedback system designed to empirically assess and track change within client systems from multisystemic and multidimensional perspectives in individual, couple, and family therapy. Clients complete the STIC Initial before the first session and the shorter STIC Intersession before every subsequent session. This study tested and its results supported the hypothesized factor structure of the six scales that comprise both STIC forms in a clinical outpatient sample and in a normal, random representative sample of the U.S. POPULATION: This study also tested the STIC's concurrent validity and found that its 6 scales and 40 of its 41 subscales differentiated the clinical and normal samples. Lastly, the study derived clinical cut-offs for each scale and subscale to determine whether and how much a client's score falls in the normal or clinical range. Beyond supporting the factorial and concurrent validity of both STIC forms, this research supported the reliabilities of the six scales (Omegahierarchical ) as well as the reliabilities of most subscales (alpha and rate-rerate). This article delineates clinical implications and directions for future research.

Laying the foundation for progress research in family, couple, and individual therapy: the development and psychometric features of the initial systemic therapy inventory of change.

This article details the development and methodological characteristics of the Systemic Therapy Inventory of Change (STIC), the first measurement system designed to assess change in family, couple, and individual therapy from a multisystemic and multidimensional perspective. The article focuses specifically on the developmental process that resulted in the five valid and reliable scales that comprise the core measure of the system, the INITIAL STIC, which is administered to clients just before beginning therapy. The scales focus on five systemic domains: individual adult, family of origin, couple, family, and individual child. This article describes the five system scales, the results of the factor analytic process that created them, as well as data on their convergent and discriminant validity.