title: Toward Treatment Integrity: Developing an Approach to Measure the Treatment Integrity of a Dialectical Behavior Therapy Intervention With Homeless Youth in the Community.
abstract: The current paper discusses an approach to measuring treatment integrity of dialectical behavioral therapy (DBT) when implemented within two programs providing services to street-involved youth in the community. Measuring treatment integrity is a critical component of effective implementation of evidence-based interventions in clinical practice, since sound treatment integrity increases confidence in client outcomes and intervention replicability. Despite being an essential part of implementation science, few studies report on treatment integrity, with limited research addressing either measurement tools or maintenance of treatment integrity. To address the lack of available treatment integrity measures, researchers in the current study developed and piloted a treatment integrity measure which pertain to the individual and group components of DBT. A total of 20 recordings were assessed using the treatment integrity measure. Results indicate that the community agency staff (e.g. youth workers, social workers & nurses) implemented the intervention as intended; increasing confidence in the outcome variables, the staffs' training and the replicability of the intervention. This article offers one approach to addressing treatment integrity when implementing evidence-based interventions, such as DBT in a community setting, and discusses the need for effective and feasible integrity measures that can be adopted in order to strengthen mental health practice in community settings.
authors.affiliation: Daphne Cockwell School of Nursing, Ryerson University, Toronto ON, Canada. Electronic address: bmccay@ryerson.ca.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: McCay
authors.affiliation: Daphne Cockwell School of Nursing, Ryerson University, Toronto ON, Canada. Electronic address: celina.carter@ryerson.ca.
authors.forename: Celina
authors.initials: C
authors.lastname: Carter
authors.affiliation: Daphne Cockwell School of Nursing, Ryerson University, Toronto ON, Canada. Electronic address: aaiello@ryerson.ca.
authors.forename: Andria
authors.initials: A
authors.lastname: Aiello
authors.affiliation: Centre for Addiction and Mental Health, Toronto ON, Canada. Electronic address: Susan.Quesnel@camh.ca.
authors.forename: Susan
authors.initials: S
authors.lastname: Quesnel
authors.affiliation: Covenant House Toronto, Toronto ON, Canada. Electronic address: Howes@covenanthouse.ca.
authors.forename: Carol
authors.initials: C
authors.lastname: Howes
authors.affiliation: Wood's Homes, Calgary AB, Canada. Electronic address: bjorn.johansson@woodshomes.ca.
authors.forename: Bjorn
authors.initials: B
authors.lastname: Johansson
mesh_terms: D000293:Adolescent; D001521:Behavior Therapy / Q000379:methods*; D055317:Evidence-Based Practice; D006282:Health Personnel / Q000193:education; D018453:Homeless Youth / Q000523:psychology*; D006801:Humans; D010043:Outcome and Process Assessment, Health Care / Q000379:methods*; D012111:Residence Characteristics; D055500:Resilience, Psychological; D013315:Stress, Psychological / Q000523:psychology