The relationship between treatment integrity and outcome in group psychotherapy: A systematic review

Abstract

Treatment integrity is defined as the extent to which the treatment has been implemented according to a specific theoretical model. It consists of two components: adherence, that is, the degree to which the therapist implements the techniques prescribed by the theoretical model, and competence, that is, the degree to which the therapist skilfully and appropriately implements the techniques prescribed by the model. Recently, the issue of integrity is gaining increasing importance in psychotherapy research, especially in an attempt to clarify its role in influencing the effectiveness of treatments. However, most studies focus on the individual setting. Therefore, this systematic review aims at investigating the relationship between integrity and outcome in group clinical treatments. Results highlighted a positive relationship between group treatment integrity and outcome. Moreover, this review provided insights for implications for research, clinical practice, and training of therapists, identifying questions that still need to be answered and tracing possible future research directions.

The assessment of therapist responsiveness in psychotherapy research: a systematic review

“…Firstly, it leads therapists to implement different treatments despite guidelines provided by theoretical manuals, characterizing itself as opposed to one of the dimensions of treatment integrity, namely adherence (Stiles, 2021). However, several researchers have shown that therapists can adhere to a treatment protocol and at the same time adapt their interventions to patients' needs (Kendall & Frank, 2018;Marques et al, 2019) with a positive impact on the therapeutic outcome (Esposito et al, 2024;Esposito et al, 2020), supporting the idea that manualized treatments may incorporate methods and techniques of other models (McAleavey & Castonguay, 2014). In this regard, Hatcher (2021) underlines the importance of integrating these two factors in order to tailor the treatment to patients' necessities while remaining within a clear theoretical framework.…”