Using treatment integrity methods to study the implementation process.

Abstract

The last decade has witnessed increased interest in the implementation and dissemination of evidence-based treatments (EBTs) for youth. Nakamura et al. (this issue) detail lessons learned over the past decade from the large-scale implementation of EBTS for children in Hawaii. This commentary discusses how lessons from Hawaii's initiative can help inform the next generation of implementation research. Specifically, we focus on how treatment integrity models and methods designed to characterize core aspects of treatment delivery can be used to study the implementation process. Using the new interactive online reporting systems developed by this research group to collect treatment integrity data offers researchers a way to determine how best to implement EBTs in community based service settings with integrity and skill.

Assessment of treatment integrity in psychotherapy research.

“…Implementation research is central to understanding the needs and preferences of clinical providers and can inform dissemination efforts. For example, researchers using the TPOCS-S found that usual care therapists utilize multiple approaches and favor nonbehavioral treatments, such as client-centered therapy (McLeod & Islam, 2011).…”

Assessing cognitive-behavioral clinical decision-making among trainees in the treatment of childhood anxiety.

“…The present study adds to a growing body of literature identifying supported tools that can be used to evaluate trainee comprehension of clinical decision-making in CBT for child anxiety. Whereas measures available to date have either required resource-intensive expert observation of actual practice behavior (McLeod & Islam, 2011) or role-plays (Beidas et al, 2012), or they may be vulnerable to biases inherent in face valid self-reports (Stumpf et al, 2009), this preliminary work on the ACE CARD begins research on brief, low-resource, vignette-based measures of clinical decision-making that requires trainees to apply knowledge to novel case material. Analyses found that the first iteration of the ACE CARD offers moderate utility in discriminating experts in CBT for anxious youth from trainees.…”

Consultants’ Perceptions of School Counselors’ Ability to Implement an Empirically-Based Intervention for Adolescent Social Anxiety Disorder

“…Demonstrating that school-based personnel, particularly those with less specialized mental health training, can implement EBTs as intended is critical for establishing program effectiveness in community settings and justifying broad implementation (McLeod & Islam, 2011). According to consultants’ judgments, school counselors were highly adherent to the SASS protocol.…”