“…The term fidelity is used to describe interventions at multiple levels including measures of systems implementation, service provision and operational principles, while adherence is used to describe the degree to which a practitioner delivers an intervention in accordance with theoretical and procedural elements of the model ( Hogue et al, 1998 ). Adherence is closely related and often differentiated from the concept of therapist competence which can be defined as the internalization and integration of attitudes, knowledge, motives, beliefs, empathy, relational understanding, clinical reasoning, emotions, values, and critical self-reflection relevant to their practice ( Epstein and Hundert, 2002 ; Baartman and de Bruijn, 2011 ; Perepletchikova, 2014 ; Cox et al, 2019 ; Crameri et al, 2020 ). In this sense, competence is what contributes to successful practice ( Antera, 2021 ).…”