title: Assessing fidelity in individual and family therapy for adolescent substance abuse.
abstract: This study introduces an observational measure of fidelity in evidence-based practices for adolescent substance abuse treatment. The Therapist Behavior Rating Scale-Competence (TBRS-C) measures adherence and competence in individual cognitive-behavioral therapy and multidimensional family therapy for adolescent substance abuse. The TBRS-C assesses fidelity to the core therapeutic goals of each approach and also contains global ratings of therapist competence. Study participants were 136 clinically referred adolescents and their families observed in 437 treatment sessions. The TBRS-C demonstrated strong interrater reliability for goal-specific ratings of treatment adherence, and modest reliability for goal-specific and global ratings of therapist competence, evidence of construct validity, and discriminant validity with an observational measure of therapeutic alliance. The utility of the TBRS-C for evaluating treatment fidelity in field settings is discussed.
authors.affiliation: The National Center on Addiction and Substance Abuse at Columbia University, New York, NY 10017-6706, USA. ahogue@casacolumbia.org
authors.forename: Aaron
authors.initials: A
authors.lastname: Hogue
authors.forename: Sarah
authors.initials: S
authors.lastname: Dauber
authors.forename: Priscilla
authors.initials: P
authors.lastname: Chinchilla
authors.forename: Adam
authors.initials: A
authors.lastname: Fried
authors.forename: Craig
authors.initials: C
authors.lastname: Henderson
authors.forename: Jaime
authors.initials: J
authors.lastname: Inclan
authors.forename: Robert H
authors.initials: RH
authors.lastname: Reiner
authors.forename: Howard A
authors.initials: HA
authors.lastname: Liddle
mesh_terms: D000293:Adolescent; D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods / Q000592:standards*; D019317:Evidence-Based Medicine; D005196:Family Therapy / Q000592:standards*; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D017410:Practice Guidelines as Topic; D011361:Professional Competence / Q000592:standards*; D015203:Reproducibility of Results; D019966:Substance-Related Disorders / Q000523:psychology / Q000534:rehabilitation*