Treatment integrity in psychotherapy research and implications for the delivery of quality mental health services.

Abstract

Treatment integrity, or the degree to which an intervention is delivered as intended, serves a crucial function as an independent variable check in treatment outcome research. Implementation science focuses on understanding and improving the processes (e.g., training, supervision, monitoring) that establish and support treatment integrity in community settings. This review assessed the adequacy of treatment integrity procedures (i.e., establishing, assessing, evaluating, and reporting integrity) implemented in treatment outcome research with the goals of updating the review by Perepletchikova, Treat, and Kazdin (2007) and connecting findings to implementation science goals. Using the Implementation of Treatment Integrity Procedures Scale (Perepletchikova et al., 2007), 2 trained raters coded the treatment integrity procedures described by randomized controlled trials of psychosocial interventions published in 6 high-impact-factor journals from 2011 to 2015 (N = 188 studies describing 270 treatments). Compared with Perepletchikova et al., current findings indicate significant improvement, but the frequency of adequate treatment integrity implementation remains low (10.7%). Recommendations for future work include focus on conceptualization of treatment integrity, establishment of treatment integrity standards, and use of findings from implementation science to improve treatment integrity procedures. (PsycINFO Database Record (c) 2019 APA, all rights reserved).