title: Development and evaluation of a treatment fidelity instrument for family-based treatment of adolescent anorexia nervosa.
abstract: OBJECTIVE
  This study provides data on the psychometric properties of a newly developed measure of treatment fidelity in Family-Based Treatment (FBT) for adolescent anorexia nervosa (AN). The Family Therapy Fidelity and Adherence Check (FBT-FACT) was created to evaluate therapist adherence and competency on the core interventions in FBT.
  
  
  METHODS
  Participants were 45 adolescents and their families sampled from three randomized clinical trials evaluating treatment for AN. Trained fidelity raters evaluated 19 therapists across 90 early session recordings using the FBT-FACT. They also rated an additional 15 session 1 recordings of an alternate form of family therapy-Systemic Family Therapy for the purpose of evaluating discriminant validity of the FBT-FACT. The process of development and the psychometric properties of the FBT-FACT are presented.
  
  
  RESULTS
  Overall fidelity ratings for each session demonstrated moderate to strong inter-rater agreement. Internal consistency of the measure was strong for sessions 1 and 2 and poor for session 3. Principal components analysis suggests sessions 1 and 2 are distinct interventions.
  
  
  CONCLUSIONS
  The FBT-FACT demonstrates good reliability and validity as a measure of treatment fidelity in the early phase of FBT.
authors.affiliation: Department of Psychiatry and Behavioral Medicine, Stanford University School of Medicine, Stanford, California.
authors.forename: Sarah
authors.initials: S
authors.lastname: Forsberg
authors.forename: Kathleen Kara
authors.initials: KK
authors.lastname: Fitzpatrick
authors.forename: Alison
authors.initials: A
authors.lastname: Darcy
authors.forename: Vandana
authors.initials: V
authors.lastname: Aspen
authors.forename: Erin C
authors.initials: EC
authors.lastname: Accurso
authors.forename: Susan W
authors.initials: SW
authors.lastname: Bryson
authors.forename: Stewart
authors.initials: S
authors.lastname: Agras
authors.forename: Katherine D
authors.initials: KD
authors.lastname: Arnow
authors.forename: Daniel
authors.initials: D
authors.lastname: Le Grange
authors.forename: James
authors.initials: J
authors.lastname: Lock
mesh_terms: D000293:Adolescent; D000856:Anorexia Nervosa / Q000628:therapy*; D005196:Family Therapy; D005260:Female; D006801:Humans; D008297:Male; D010349:Patient Compliance; D011594:Psychometrics / Q000295:instrumentation*; D015203:Reproducibility of Results; D016896:Treatment Outcome
keywords: anorexia nervosa; family based treatment; psychometric assessment; treatment fidelity measurement