A pragmatic approach to measuring adherence in treatment delivery in psychotherapy.
Cogn Behav Ther
; 49(5): 347-360, 2020 09.
Article
en En
| MEDLINE
| ID: mdl-32114905
ABSTRACT
Measuring therapists' adherence to treatment manuals is recommended for evaluating treatment integrity, yet ways to do this are poorly defined, time consuming, and costly. The aims of the study were to develop a Therapy Component Checklist (TCC) to measure adherence to manualised CBT; to test its application in research and clinical practice; to determine its validity; and consider its cost benefits. We conducted a randomised trial in 230 people with cancer evaluating effectiveness of CBT for depression. In this, therapists delivered manualised treatment. Experts agreed on key components of therapy and therapists were asked to record these after therapy sessions by ticking a TCC. Inter-rater reliability was tested using an independent rater. Therapists delivered 543 CBT sessions. TCCs were completed in 293, of which 39 were assessed by the independent rater. Self-reported TCC data suggested close adherence to the manual. Prevalence-adjusted and bias-adjusted kappa scores suggested substantial agreement, (>0.60) in 38 out of 46 items. Self-rating of adherence saved around £96 per rating. In conclusion the TCC provides a quick and cost effective way of evaluating the components of therapy delivered. This approach could be applied to other psychological treatments and may help with linking therapeutic interventions with outcome.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Terapia Cognitivo-Conductual
/
Competencia Clínica
/
Lista de Verificación
Tipo de estudio:
Clinical_trials
/
Guideline
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
Cogn Behav Ther
Asunto de la revista:
CIENCIAS DO COMPORTAMENTO
/
TERAPEUTICA
Año:
2020
Tipo del documento:
Article
País de afiliación:
Reino Unido