title: Longitudinal determinants of client treatment satisfaction in an intensive first-episode psychosis treatment programme.
abstract: Previous evidence demonstrates that higher treatment satisfaction is strongly associated with improved clinical outcomes and functioning. The aim of the current study is to explore potential associations between clinical and demographic attributes, as well as changes in role, social and cognitive functioning occurring over the course of treatment, on self-reported treatment satisfaction within the context of an intensive first-episode psychosis intervention programme.
  
  
  
  Forty-four young adults attending a first-episode psychosis treatment programme completed a battery of clinical and neuropsychological measures at intake to the programme and again after 6 months of treatment. A modified version of the Client Satisfaction Questionnaire was administered at 6 months. Baseline, 6-month and change scores across the clinical and demographic measures were examined relative to the satisfaction questionnaire to evaluate determinants of treatment satisfaction.
  
  
  
  Better premorbid adjustment during childhood and early adolescence was associated with higher treatment satisfaction, as did positive changes in clients' cognitive performance and their use of humour as a coping strategy. Clients' use of emotional support as a coping strategy at 6 months was also positively associated with treatment satisfaction. Although clients' social and role functioning improved significantly during the 6-month treatment window, changes in functional outcomes were not significantly associated with treatment satisfaction.
  
  
  
  The current study highlights the role of premorbid adjustment and changes in coping and neurocognition as factors influencing treatment satisfaction. Future research designs might be able to more specifically ascertain causal relationships between patient characteristics, treatment components, client satisfaction and clinical effects.
authors.affiliation: Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.|Division of Schizophrenia Research, Rutgers University Behavioral Health Care, Piscataway, New Jersey, USA.
authors.forename: Lisa N
authors.initials: LN
authors.lastname: Cruz
authors.affiliation: Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
authors.forename: Emily
authors.initials: E
authors.lastname: Kline
authors.affiliation: Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
authors.forename: Larry J
authors.initials: LJ
authors.lastname: Seidman
authors.affiliation: Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.|Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA.
authors.forename: Kyle S
authors.initials: KS
authors.lastname: Minor
authors.affiliation: Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.|VA VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, USA.|Central Texas Veterans Healthcare System, Texas A&M University Health Science Center, Temple, Texas, USA.|College of Medicine, Texas A&M University Health Science Center, Temple, Texas, USA.
authors.forename: Eric C
authors.initials: EC
authors.lastname: Meyer
authors.affiliation: Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
authors.forename: Carina
authors.initials: C
authors.lastname: Iati
authors.affiliation: Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
authors.forename: Suzanna V
authors.initials: SV
authors.lastname: Zimmet
authors.affiliation: Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Friedman-Yakoobian
mesh_terms: D000223:Adaptation, Psychological; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D017060:Patient Satisfaction; D011618:Psychotic Disorders / Q000523:psychology* / Q000628:therapy; D012917:Social Adjustment; D055815:Young Adult
keywords: community mental health service; consumer satisfaction; programme evaluation; psychotic disorder; schizophrenia