This study meta-analytically examined the effect of treatment integrity on client outcomes of evidence-based interventions for juveniles with antisocial behavior. A total of 17 studies, from which 91 effect sizes could be retrieved, were included in the present 3-level meta-analysis. All included studies, to a certain level, adequately implemented procedures to establish, assess, evaluate and report the level of treatment integrity. A moderator analysis revealed that a medium-to-large effect of evidence-based interventions was found when the level of treatment integrity was high (d = 0.633, p b 0.001), whereas no significant effect was found when integrity was low (d = 0.143, ns). Treatment integrity was significantly associated with effect size even when adjusted for other significant moderators, indicating the specific contribution of high levels of treatment integrity to positive client outcomes. This implies that delivering interventions with high treatment integrity to youth with antisocial behavior is vital.
Few evidence-based methods for case management in child protection and child welfare are available. That is why Youth Protection Amsterdam Area developed a new method, by integrating their best practices: Intensive Family Case Management (IFCM). Because IFCM was developed in practice, clarity about its core elements and behavior acts was lacking. The purpose of this study was to establish a valid operationalization of IFCM used for implementation purposes such as training, clinical supervision and monitoring. A 74-item draft was developed to describe the behavioral acts of IFCM, based on a literature study and analysis of internal documents and training. To ensure content validity, a Delphi study was conducted. Over two rounds, professionals (1) rated the behavioral acts needed in the application of IFCM on a five-point Likert scale and (2) provided their preferred terminology. Items with consensus ratings of 80 % or more were included in the final description. Selected IFCM experts rated the behavior acts over two rounds. The initial list with 74 behavior acts was reduced to 55 acts with a consensus of 80 % or more.Certain behavior acts were combined, others did not lead to consensus. Based on experts' feedback, the initial terminology of 46 behavior acts was modified. The final 55 acts were categorized in ten core elements. This study explicates the core elements of IFCM and describes the 55 necessary behavior acts in preferred and recognizable terminology. The study describes implications of these findings for the practice and gives recommendations for future research.
Objective: This systematic review evaluates the content of effective support provided to practitioners of evidence-based interventions in order to establish and maintain treatment integrity. Method: Four articles covering six outcome studies are included in this review, these studies (1) adequately operationalized treatment integrity procedures and (2) showed sufficient effects of the support on levels of treatment integrity. Results: The results show that an effective support system consists of a minimum combination of training and ongoing support (supervision, consultation, and coaching), preferably extended with booster sessions. Conclusions: The review provides specific information on effective content of this support which practitioners and intervention developers can use in order to establish and maintain treatment integrity of their planned interventions.
This systematic review evaluates the implementation of treatment integrity procedures in outcome studies of youth interventions targeting behavioral problems. The Implementation of Treatment Integrity Procedures Scale (ITIPS), developed by Perepletchikova, Treat, and Kazdin (2007) , was adapted (ITIPS-A) and used to evaluate 32 outcome studies of evidence-based interventions for youths with externalizing behavioral problems. Integrity measures were found to be still rare in these studies. Of the studies that took integrity into account, 80% approached adequacy in implementing procedures for treatment integrity. The ITIPS-A is recommended as an instrument to guide development of integrity instruments and the implementation of treatment integrity procedures in youth care.
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