title: Adolescent and parent motivation for change affects psychotherapy outcomes among youth with poorly controlled diabetes.
abstract: OBJECTIVE
  Investigate effect of baseline motivation for change on treatment fidelity, therapeutic alliance, treatment dose, and treatment outcome in a randomized controlled trial of family therapy for youth with poorly controlled diabetes.
  
  
  METHODS
  Seventy-four adolescents and caregivers completed measures of motivation for change. Measures of fidelity, alliance, dose, and youth health status were collected. Structural equation modeling was used to test the direct and indirect effects of motivation on treatment outcomes.
  
  
  RESULTS
  Parent motivation was significantly related to alliance and fidelity. Only alliance was significantly related to posttreatment metabolic control. In adolescent models, only motivation was significantly related to alliance. In both models, motivation had a significant indirect effect on metabolic control through alliance.
  
  
  CONCLUSIONS
  Findings demonstrate the importance of parent and youth initial motivational status and treatment alliance to treatment outcome among youth with poorly controlled diabetes. Additional research on treatment techniques that promote motivation for change is needed.
authors.affiliation: Pediatric Prevention Research Center, Old Hutzel Hospital, Detroit, MI 48201, USA. dellis@med.wayne.edu
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Ellis
authors.forename: Heidi
authors.initials: H
authors.lastname: Berio
authors.forename: April Idalski
authors.initials: AI
authors.lastname: Carcone
authors.forename: Sylvie
authors.initials: S
authors.lastname: Naar-King
mesh_terms: D000293:Adolescent; D000328:Adult; D001521:Behavior Therapy / Q000379:methods*; D003920:Diabetes Mellitus / Q000523:psychology* / Q000628:therapy; D005196:Family Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010290:Parents / Q000523:psychology*; D016896:Treatment Outcome