Validity of therapist self-report ratings of fidelity to evidence-based practices for adolescent behavior problems: correspondence between therapists and observers.
Validity of therapist self-report ratings of fidelity to evidence-based practices for adolescent behavior problems: correspondence between therapists and observers.
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DOI：
10.1007/s10488-014-0548-2
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发表时间：
2015-03
期刊：
影响因子：
--
通讯作者：
Henderson CE
中科院分区：
文献类型：
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作者：
Hogue A;Dauber S;Lichvar E;Bobek M;Henderson CE
开发治疗师报告保真度工具，以支持常规护理中循证实践的高质量交付，是实施科学的重中之重。本研究测试了两组社区治疗师在对有行为和物质使用问题的市中心青少年进行常规治疗时使用家庭治疗（FT）和动机访谈/认知行为治疗（MI/CBT）干预的可靠性和准确性。研究病例（n = 45）随机分为两组：(a)常规家庭治疗（RFT），包括一个以家庭治疗为行为治疗标准护理的单一场所；或(b)照常治疗（TAU），由五个以非家庭方法为特色的地点组成。治疗师和训练有素的观察评分者对157个疗程（104个RFT， 53个TAU）提供FT和MI/CBT依从性评分。总体治疗师的可靠性对于平均FT评分是足够的（ICC = .66），但对于MI/CBT几乎不存在（ICC = .06）；此外，RFT和TAU治疗师在报告FT方面比MI/CBT更可靠。两组治疗师都高估了他们实施FT和MI/CBT干预的程度。研究结果支持使用现有的治疗师报告方法在现实环境中锚定FT干预的质量保证程序的可行性，但不支持MI/CBT。
Developing therapist-report fidelity tools to support quality delivery of evidence-based practices in usual care is a top priority for implementation science. This study tested the reliability and accuracy of two groups of community therapists who reported on their use of family therapy (FT) and motivational interviewing/cognitive-behavioral therapy (MI/CBT) interventions during routine treatment of inner-city adolescents with conduct and substance use problems. Study cases (n = 45) were randomized into two conditions: (a) Routine Family Therapy (RFT), consisting of a single site that featured family therapy as its standard of care for behavioral treatment; or (b) Treatment As Usual (TAU), consisting of five sites that featured non-family approaches. Therapists and trained observational raters provided FT and MI/CBT adherence ratings on 157 sessions (104 RFT, 53 TAU). Overall therapist reliability was adequate for averaged FT ratings (ICC = .66) but almost non-existent for MI/CBT (ICC = .06); moreover, both RFT and TAU therapists were more reliable in reporting on FT than on MI/CBT. Both groups of therapists overestimated the extent to which they implemented FT and MI/CBT interventions. Results offer support for the feasibility of using existing therapist-report methods to anchor quality assurance procedures for FT interventions in real-world settings, though not for MI/CBT.