title: Initial development of a treatment adherence measure for cognitive-behavioral therapy for child anxiety.
abstract: The measurement of treatment adherence (a component of treatment integrity defined as the extent to which a treatment is delivered as intended) is a critical element in treatment evaluation research. This article presents initial psychometric data for scores on the Cognitive-Behavioral Therapy Adherence Scale for Youth Anxiety (CBAY-A), an observational measure designed to be sensitive to common practice elements found in individual cognitive-behavioral therapy (ICBT) for youth anxiety. Therapy sessions (N = 954) from 1 efficacy and 1 effectiveness study of ICBT for youth anxiety were independently rated by 2 coders. Interrater reliability (as gauged by intraclass correlation coefficients) for the item scores averaged 0.77 (SD = 0.15; range .48 to .80). The CBAY-A item and scale (skills, model, total) scores demonstrated evidence of convergent and discriminant validity with an observational measure of therapeutic interventions and an observational measure of the alliance. The CBAY-A item and scale scores also discriminated between therapists delivering ICBT in research and practice settings and therapists delivering nonmanualized usual clinical care. We discuss the importance of replicating these psychometric findings in different samples and highlight possible application of an adherence measure in testing integrity-outcome relations.
authors.affiliation: Department of Psychology, Virginia Commonwealth University.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Southam-Gerow
authors.affiliation: Department of Psychology, Virginia Commonwealth University.
authors.forename: Bryce D
authors.initials: BD
authors.lastname: McLeod
authors.affiliation: Department of Psychology, Virginia Commonwealth University.
authors.forename: Cassidy C
authors.initials: CC
authors.lastname: Arnold
authors.affiliation: Department of Psychology, Virginia Commonwealth University.
authors.forename: Adriana
authors.initials: A
authors.lastname: Rodríguez
authors.affiliation: Department of Psychology, Virginia Commonwealth University.
authors.forename: Julia R
authors.initials: JR
authors.lastname: Cox
authors.affiliation: Department of Psychology, University of California-Los Angeles.
authors.forename: Steven P
authors.initials: SP
authors.lastname: Reise
authors.affiliation: Department of Psychology, University of California-Los Angeles.
authors.forename: Wesley E
authors.initials: WE
authors.lastname: Bonifay
authors.affiliation: Department of Psychology, Harvard University.
authors.forename: John R
authors.initials: JR
authors.lastname: Weisz
authors.affiliation: Department of Psychology, Temple University.
authors.forename: Philip C
authors.initials: PC
authors.lastname: Kendall
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders / Q000628:therapy*; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D015588:Observer Variation; D017410:Practice Guidelines as Topic; D011594:Psychometrics; D015203:Reproducibility of Results