How do components of evidence-based psychological treatment cluster in practice?

Validity of Therapist Self-Report Ratings of Fidelity to Evidence-Based Practices for Adolescent Behavior Problems: Correspondence between Therapists and Observers

“…Perhaps FT is better suited for therapist-report formats because most FT techniques are linked to the physical presence of family members; perhaps the techniques themselves are more easily operationalized in a manner that avails reliable self-reporting; perhaps this particular sample of community therapists lacked an adequate level of expertise in the MI and CBT approaches to engender reliable reporting. Whatever the reasons, given past failures to establish therapist reliability in fidelity reporting on MI (e.g., Martino et al 2009; Miller et al 2004) and CBT (e.g., Brosan et al 2008; Carroll et al 1998) across various client populations, the field remains stuck at the drawing board in creating viable therapist-report tools for these two approaches, both of which are widely endorsed in the clinical workforce (Cook et al 2010; Gifford et al 2012). …”

“…Currently there is only a handful of therapist-report fidelity tools designed to assess core EBIs commonly used in everyday practice, including measures for adult depression (Hepner et al 2010), adult substance use (Gifford et al 2012), childhood disruptive behavior (Hurlburt et al 2010), and broad child psychotherapy approaches (Bearsley-Smith et al 2008; Weersing et al 2002). Although developing new therapist-report tools for other clinical populations could advance EBI dissemination in several ways, there remains a major hurdle to clear: Studies attempting to confirm therapist self-reports of EBI implementation via observational ratings have mostly produced disappointing results, casting doubt on the accuracy with which therapists can judge their own performances.…”

“…The derivation of ITTABP items is detailed in the “Measures” section; the items are listed in Table 2. These four approaches were included in the ITT-ABP because each has a substantial base of empirical support for addressing adolescent conduct, delinquency, and substance use problems (for reviews see Becker and Curry 2008; Chorpita et al 2011; see also Winters et al 2007) and are widely endorsed in front-line settings (Cook et al 2010; Gifford et al 2012). The CBT, FT, and MI approaches each boast several manualized versions that have proven efficacious for treating a range of ABPs, which makes them ideal candidates to supply core EBIs capable of addressing a variety of treatment needs.…”

“…As described in Methods, ITT-ABP items derive from two observational fidelity scales that were validated during controlled trials of empirically supported treatments. There is considerable enthusiasm for using observational measures forged in controlled trials as the foundation for developing QA tools for usual care (Gifford et al 2012; Schoenwald et al 2011), on the premise that this will yield instruments with both strong psychometric properties and clinical validity in measuring EBPs.…”

Randomized Trial of Family Therapy Versus Nonfamily Treatment for Adolescent Behavior Problems in Usual Care

“…This study assessed the extent to which study sessions contained treatment techniques representing two evidence-based approaches for ABPs: FT and MI/CBT. MI/CBT interventions were assessed because, like FT, they are considered evidence-based approaches for treating ABPs (Chorpita et al, 2011; Tanner-Smith et al, 2012) and are widely endorsed in front-line settings (Cook, Biyanora, Elhai, Schnurr, & Coyne, 2010; Gifford et al, 2012). Observers used validated model-specific fidelity measures to rate the extent to which FT techniques (8 items; Cronbach’s α = .72) and MI/CBT techniques (8 items; Cronbach’s α = .62) were utilized in session based on a 5-point scale: 1 = Not at all , 2 = A little bit , 3 = Moderately , 4 = Considerably , 5 = Extensively .…”