title: Assessing fidelity to evidence-based practices in usual care: the example of family therapy for adolescent behavior problems.
abstract: This study describes a multimethod evaluation of treatment fidelity to the family therapy (FT) approach demonstrated by front-line therapists in a community behavioral health clinic that utilized FT as its routine standard of care. Study cases (N=50) were adolescents with conduct and/or substance use problems randomly assigned to routine family therapy (RFT) or to a treatment-as-usual clinic not aligned with the FT approach (TAU). Observational analyses showed that RFT therapists consistently achieved a level of adherence to core FT techniques comparable to the adherence benchmark established during an efficacy trial of a research-based FT. Analyses of therapist-report measures found that compared to TAU, RFT demonstrated strong adherence to FT and differentiation from three other evidence-based practices: cognitive-behavioral therapy, motivational interviewing, and drug counseling. Implications for rigorous fidelity assessments of evidence-based practices in usual care settings are discussed.
authors: National Center on Addiction and Substance Abuse at Columbia University, New York, NY 10017, USA. ahogue@casacolumbia.org
authors: Aaron
authors: A
authors: Hogue
authors: Sarah
authors: S
authors: Dauber
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D019985:Benchmarking; D019955:Conduct Disorder / Q000523:psychology / Q000534:rehabilitation*; D055317:Evidence-Based Practice; D005196:Family Therapy; D005260:Female; D006801:Humans; D008297:Male; D015397:Program Evaluation; D000297:Psychology, Adolescent; D019966:Substance-Related Disorders / Q000523:psychology / Q000534:rehabilitation*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014743:Videotape Recording