Development of the emotionally focused individual therapy adherence measure: Conceptualisation and preliminary reliability

Abstract

The Emotionally Focused Individual Therapy Adherence Measure (EFIT-AM) is presented as a scale to measure a therapist's adherence to the EFIT model. The theoretical rationale for EFIT as a promising model of individual therapy and conceptual development of EFIT-AM are introduced. The EFIT-AM was developed to measure therapist adherence to treatment tasks when working specifically with clients presenting with negative emotional disorder and can be used to promote therapist education and development in training and supervision. The measure includes assessment of essential skills, meta-themes, and stages of EFIT. The measure was piloted using participants (n = 20) with advanced training in EFT. Participants used the measure to rate therapist adherence to EFIT model by observing a recorded therapy session of an expert EFIT therapist. Participant ratings were used to examine consistency among ratings of therapist behaviour and to receive feedback regarding the user experience of the EFIT-AM. Mean item ratings of three and five within the same talk turn were considered to signify reliable identification of an EFIT skill. Of the 18 adherence items on the EFIT-AM, 12 items met our criteria for 50% of participants identifying the item at the same time with a rating of three or five. Six items did not meet these criteria and were considered to either occur at a session, as opposed to talk turn, level or in need of consolidation. The high level of inter-rater reliability and internal consistency of the EFIT-AM indicates the EFIT-AM is a promising tool to evaluate therapist adherence.