FIDELITY SCALE: INTRODUCTION
Overview of FPE
FPE is an evidence-based psychiatric rehabilitation practice that aims to achieve the best possible outcome for consumers with severe mental illness (SMI) through collaborative treatment between clinicians and family members of the individual with SMI. Additionally, FPE attempts to alleviate the stress experienced by family members by supporting them in their efforts to aid the recovery of their loved one. Research has demonstrated that FPE results in a 20% - 50% reduction in relapse and rehospitalization rates among consumers whose families received psychoeducation than among those receiving standard individual services (Lam, Knipers & Leff, 1993; Penn & Kim, 1996; Falloon, Held et al., 1999). Moreover, families that receive education and support feel less burden and are more effective at helping their loved ones with SMI to manage their illnesses (Dixon & Lehman, 1995).
Although the existing models of family interventions vary, leaders in the field have reached a consensus on the critical ingredients of effective FPE. They include a collaborative relationship between the treatment team and family, basic psychoeducation about psychiatric illness and its management, social support and empathy, interventions targeted to reducing tension and stress in the family as well as improving functioning in all family members (and not just the consumer), and a program length of six months or more (Dixon, McFarlane et al., 2001).
What is meant by family?
The term family is used throughout this document. It should be interpreted broadly to including anyone in the clients natural support system who is functioning as family, regardless of any legal or biological relationship to the client. A family member could include not only parents, siblings, spouses, children, and other relatives, but also friends.
Overview of the scale
The 12-item FPE Fidelity Scale has been developed to measure the adequacy of implementation of FPE programs. Each item on the scale is rated on a 5-point rating scale ranging from 1 (Not implemented) to 5 (Fully implemented). The standards used for establishing the anchors for the fully-implemented ratings were determined through a variety of expert sources as well as empirical research.
What is rated
The scale is rated on current behavior and activities, not planned or intended behavior. For example, in order to get the full credit for Item 1 (Family Intervention Coordinator), it is not enough that the program is currently planning to hire personnel to fill the position.
Unit of analysis
The scale is appropriate for organizations that are serving clients with SMI and their families. The purpose of the scale is to assess fidelity to evidence-based practices at the program level, rather than at the level of a specific clinician.
Family Psychoeducation Toolkit