The importance of assessing treatment integrity: An example in the anxiety disorders

Vermilyea, Bonnie B.; Barlow, David H.; O’Brien, Gregory

doi:10.1007/bf01321456

Cited by 50 publications

(28 citation statements)

References 9 publications

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“…Treatment or intervention fidelity, also known as treatment/intervention integrity signifies the extent to which a treatment is implemented as intended (Vermilyea et al 1984;Yeaton & Sechrest, 1981). Treatment fidelity measures are crucial to psychological interventions, both to ascertain their efficacy (i.e., how well they work under 'ideal' highly controlled settings such as clinical trials) and their effectiveness (i.e., how well they work in the 'real-world').…”

Section: Introductionmentioning

confidence: 99%

Inter-rater reliability of treatment fidelity and therapeutic alliance measures for psychological therapies for anxiety in young people with autism spectrum disorders

Brown

Iqbal

Reynolds

et al. 2014

International Journal of Developmental Disabilities

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Abstract:Objectives: This article presents work undertaken to establish inter-rater reliability for a measure of treatment fidelity and a measure of therapeutic alliance for therapies for anxiety for young people with autism spectrum disorders. The discussion and decision-making processes behind achieving consensus of raters are rarely published. Margolin et al. (1998) have highlighted this issue and called for researchers to communicate the details of their observational and rating procedures. This article is a response to their call for greater transparency so that these methods are readily accessible for comparison with other studies. Methods: Participants were young people with autism spectrum disorders receiving treatment for anxiety, clinical staff treating these young people and the independent raters assessing the treatment sessions.We report: (a) the processes involved in establishing inter-rater reliability for two instruments (b) the results obtained with a sample of young people with autism spectrum disorders using these instruments.Results and conclusions Results demonstrate that it was possible to attain satisfactory inter-rater reliability with each of these two instruments with a client group with autism spectrum disorders, even though the instruments were originally designed for typically-developing populations. Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation&*:r,,:l-*1',k*H 6.ln cases where the article is a translation of a previously published article, the author(s) warrant(s) that full permission has been obtained to carry out and publish the translation of the article from its original language, and that it in no way infringes the rights of others (including the holders of copyright in material used within the originalArticle).7. The author(s) warrant(s) that the article contains no plagiarised material and agree(s) that the article may be checked for plagiarism and other ethical questions (including checks using automated software packages). The Publisher reserves the right to withdraw or retract any article for which, in its reasonable opinion, valid concerns exist over the originality of the article, or its compliance with the Journal's ethical policy. Maney's plagiarism and ethical policy may be read in fullat www. manevonline.com/paoe/authors/publishinqethics-oeneral."lf the author(s) cannot assign copyright for any or all the supplementary material, the clause in parentheses should be struck out and a licence to publish provided for this material. lf copyright is held by a third party, permission to reproduce this material must be obtained from the copyright holder as laid out in paragraph 5 of this form and submitted to the publisher. Copyright AssignmentI confirm that all the co-authors, named above in 1, know that the article has been submitted to the Journal. ')' to ensure the widest possible disseminatiori ""J pr"t".!ion ot irticter pr6ri.n"o in tlie'Journal, we request authors to assign worldwide copyright in print, digital and otneimiiia in t...

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Section: Introductionmentioning

confidence: 99%

Inter-rater reliability of treatment fidelity and therapeutic alliance measures for psychological therapies for anxiety in young people with autism spectrum disorders

Brown

Iqbal

Reynolds

et al. 2014

International Journal of Developmental Disabilities

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“…In psychotherapy outcome research, treatment integrity refers to the extent to which the intervention was implemented as intended [19]. It usually includes three determining components: treatment adherence, therapist competence and treatment differentiation [20].…”

Section: Resultsmentioning

confidence: 99%

The implementation of mentalization-based treatment for adolescents: a case study from an organizational, team and therapist perspective

Hutsebaut

Bales

Busschbach

et al. 2012

Int J Ment Health Syst

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BackgroundReports on problems encountered in the implementation of complex interventions are scarce in psychotherapy literature. This is remarkable given the inherent difficulties of such enterprises and the associated safety risks for patients involved.Case descriptionA case study of the problematic implementation process of Mentalization- Based Treatment for Adolescents (MBT-A), a new therapy for 14 to 18 year old youngsters with severe personality disorders, is presented. The implementation process is described and analyzed at an organizational, team and therapist level.Discussion and evaluationOur analysis shows that problems at all three levels contributed and interacted to make the implementation cumbersome and hazardous.ConclusionThe implementation of complex psychotherapeutic programs for difficult patients could benefit from a structured attention to processes at multiple levels. We therefore propose a new comprehensive heuristic model of treatment integrity. This new model includes organisational, team and therapist adherence to the treatment model as necessary components of treatment integrity in the implementation of complex interventions. The application of this new model of treatment integrity potentially increases the chance of successful implementations and reduces safety risks for first patients enrolling in a new program.

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“…Consequently, it was assumed that patients received the interventions they were supposed to receive as designed [8]. Studies in the early eighties however, showed that this belief was flawed [9,10]. Recognition of the importance of establishing fidelity emerged from the difficult, if not impossible comparison of effectiveness, the growing emphasis on accountability, and the gap between research and practice [8].…”

Section: Introductionmentioning

confidence: 99%

The Prevention and Reactivation Care Program: intervention fidelity matters

Vos

Bakker²,

Vreede

et al. 2013

BMC Health Serv Res

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BackgroundThe Prevention and Reactivation Care Program (PReCaP) entails an innovative multidisciplinary, integrated and goal oriented approach aimed at reducing hospital related functional decline among elderly patients. Despite calls for process evaluation as an essential component of clinical trials in the geriatric care field, studies assessing fidelity lag behind the number of effect studies. The threefold purpose of this study was (1) to systematically assess intervention fidelity of the hospital phase of the PReCaP in the first year of the intervention delivery; (2) to improve our understanding of the moderating factors and modifications affecting intervention fidelity; and (3) to explore the feasibility of the PReCaP fidelity assessment in view of the modifications.MethodsBased on the PReCaP description we developed a fidelity instrument incorporating nineteen (n=19) intervention components. A combination of data collection methods was utilized, i.e. data collection from patient records and individual Goal Attainment Scaling care plans, in-depth interviews with stakeholders, and non-participant observations. Descriptive analysis was performed to obtain levels of fidelity of each of the nineteen PReCaP components. Moderating factors were identified by using the Conceptual Framework for Implementation Fidelity.ResultsTen of the nineteen intervention components were always or often delivered to the group of twenty elderly patients. Moderating factors, such as facilitating strategies and context were useful in explaining the non- or low-adherence of particular intervention components.ConclusionsFidelity assessment was carried out to evaluate the adherence to the PReCaP in the Vlietland Ziekenhuis in the Netherlands. Given that the fidelity was assessed in the first year of PReCaP implementation it was commendable that ten of the nineteen intervention components were performed always or often. The adequate delivery of the intervention components strongly depended on various moderating factors. Since the intervention is still developing and undergoing continuous modifications, it has been concluded that the fidelity criteria should evolve with the modified intervention. Furthermore, repeated intervention fidelity assessments will be necessary to ensure a valid and reliable fidelity assessment of the PReCaP.Trial registrationThe Netherlands National Trial Register: NTR2317

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The importance of assessing treatment integrity: An example in the anxiety disorders

Abstract: One purpose of this investigation was to examine the importance of assessing treatment integrity in a study

Cited by 50 publications

References 9 publications

Inter-rater reliability of treatment fidelity and therapeutic alliance measures for psychological therapies for anxiety in young people with autism spectrum disorders

Inter-rater reliability of treatment fidelity and therapeutic alliance measures for psychological therapies for anxiety in young people with autism spectrum disorders

The implementation of mentalization-based treatment for adolescents: a case study from an organizational, team and therapist perspective

The Prevention and Reactivation Care Program: intervention fidelity matters

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