Implementation of Treatment Integrity Procedures

Goense, Pauline; Boendermaker, Leonieke; Yperen, Tom van; Stams, Geert Jan; Laar, Jose van

doi:10.1027/2151-2604/a000161

Cited by 25 publications

(14 citation statements)

References 46 publications

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“…Despite the importance of treatment integrity, scientists have not afforded much attention to its measurement and study. Reviews of the treatment integrity literature have concluded that measurement of the construct is lacking (e.g., Perepletchikova, Treat, & Kazdin, 2007; Webb, DeRubeis, & Barber, 2010), particularly in the area of child and adolescent (hereafter, youth) treatment (Goense, Boendermaker, van Yperen, Stams, & van Laar, 2014; McLeod, Southam-Gerow, & Weisz, 2009). The integrity measurement that has been reported usually focuses on verifying the presence of the independent variable, assessed in a binary fashion (e.g., Perepletchikova et al, 2007; Schoenwald et al, 2011).…”

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confidence: 99%

Generalizability and Decision Studies of a Treatment Adherence Instrument

et al. 2018

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Observational measurement of treatment adherence has long been considered the gold standard. However, little is known about either the generalizability of the scores from extant observational instruments or the sampling needed. We conducted generalizability (G) and decision (D) studies on two samples of recordings from two randomized controlled trials testing cognitive-behavioral therapy for youth anxiety in two different contexts: research versus community. Two doctoral students independently coded 543 session recordings from 52 patients treated by 13 therapists. The initial G-study demonstrated that context accounted for a disproportionately large share of variance, so we conducted G- and D-studies for the two contexts separately. Results suggested that reliable cognitive-behavioral therapy adherence studies require at least 10 sessions per patient, assuming 12 patients per therapists and two coders-a challenging threshold even in well-funded research. Implications, including the importance of evaluating alternatives to observational measurement, are discussed.

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confidence: 99%

Generalizability and Decision Studies of a Treatment Adherence Instrument

et al. 2018

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“…Treatment integrity refers to the degree to which a treatmentwas delivered as intended and is comprised of adherence (carrying out procedures called for in the model), differentiation ( not carrying out procedures that are proscribed in the model), and competence (the quality of treatment delivery;Perepletchikova& Kazdin, 2005). Reviews have concluded that few clinical trials have assessed allcomponents(Goense, Boendermaker, van Yperen, Stams, & van Laar, 2014; Perepletchikova, Treat, & Kazdin, 2007). Of the integrity components, adherence has received most attention, but competence is understudied in the child and adolescent (hereafter, youth) treatment field (Goense et al, 2014; Perepletchikova et al, 2007).…”

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confidence: 99%

“…Reviews have concluded that few clinical trials have assessed allcomponents(Goense, Boendermaker, van Yperen, Stams, & van Laar, 2014; Perepletchikova, Treat, & Kazdin, 2007). Of the integrity components, adherence has received most attention, but competence is understudied in the child and adolescent (hereafter, youth) treatment field (Goense et al, 2014; Perepletchikova et al, 2007). …”

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confidence: 99%

Development and Initial Psychometrics for a Therapist Competence Instrument for CBT for Youth Anxiety

McLeod

Southam‐Gerow

Rodríguez

et al. 2016

Journal of Clinical Child & Adolescent Psychology

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Objective: Therapistcompetence is an important component of treatment integrity. This paper reports on the development and initial psychometric assessment of the Cognitive-Behavioral Treatment for Anxiety in Youth Competence Scale (CBAY-C), an observational instrumentdesigned to capture therapist limited-domain competence (i.e., competence in the delivery of core interventions and delivery methods found in a specific psychosocialtreatment program) in the delivery of the core practice elements in individual cognitive-behavioral treatment (ICBT) for youth anxiety. Method: Treatment sessions (N = 744) from 68 youth participants (M age = 10.60 years, SD = 2.03; 82.3% Caucasian; 52.9% male) of the same ICBT program for youth anxiety from (a) an efficacy study and (b) an effectiveness study were independently scored by four coders using observational instruments designed to assess therapist competence, treatment adherence, treatment differentiation, alliance, and client involvement. Results: Inter-rater reliability (intraclass correlation coefficients, ICC(2,2)) for the item scores averaged 0.69 (SD = 0.11). The CBAY-C item, scale, and subscale (Skills, Exposure) scores showed evidence of validity via associations with observational instruments of treatment adherence to ICBT for youth anxiety, theory-based domains (CBT, psychodynamic, family, client-centered), alliance, and client involvement. Importantly, although the CBAY-Cscale, subscale, and item scores did overlap with a corresponding observational treatment adherence instrument independently rated by coders,the degree of overlap was moderate, indicating that theCBAY-C assessesa distinct component of treatment integrity. Conclusions: Applications of the instrument and future research directions discussed include the measurement of treatment integrity and testing integrity-outcome relations.

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“…Manipulation checks (adherence and competence) used in psychotherapy trials to confirm therapists followed the treatment manual in delivery of the therapy has been linked to enhanced treatment fidelity [47,[50][51][52]. A user-friendly Check List (shaped in part by the Program Logic Model Framework) was incorporated to aid in the order of activity delivery.…”

Section: Mbct-self Assessment Scale Manualmentioning

confidence: 99%

The Development of a MBCT Self-Assessment Scale

Prowse

Nagel²,

Meadows

2015

J Depress Anxiety

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Measuring the treatment distinctiveness of MBCT allows the unique features and structured program of cognitive therapy and mindfulness skills to be better understood [8]. This information helps provide a clearer picture of whether the implemented treatment was effective in AbstractMindfulness Based Cognitive Therapy (MBCT) continues to gain evidential support as an intervention to impact on relapse and recurrence of depression. Researchers and MBCT Clinicians seek higher levels of treatment fidelity to maximise positive outcomes, through the use of treatment manuals, assessment scales and other supporting tools. Semi-structured group interviews with MBCT trained clinicians and subsequent thematic analysis, identified core elements of a new MBCT Self-Assessment scale and benefits, challenges, and enablers to implementation of MBCT training. The study findings support inclusion of an MBCT-Self Assessment Scale in MBCT Program implementation and suggest a range of other practical strategies for improved treatment fidelity.

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Implementation of Treatment Integrity Procedures

Cited by 25 publications

References 46 publications

Generalizability and Decision Studies of a Treatment Adherence Instrument

Generalizability and Decision Studies of a Treatment Adherence Instrument

Development and Initial Psychometrics for a Therapist Competence Instrument for CBT for Youth Anxiety

The Development of a MBCT Self-Assessment Scale

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