Ensure Treatment Fidelity Research Articles

Establishing Treatment Fidelity in a Web-Based Behavioral Intervention Study

: Treatment fidelity pertains to the methodological strategies used to monitor and enhance the reliability and validity of behavioral interventions. Approaches to establishing treatment fidelity in Web-based interventions differ from those used in interventions that are delivered in person. : The aim of this study was to describe a methodology for ensuring treatment fidelity in a Web-based cognitive behavioral stress management intervention. : The intervention Coping With Cancer Workbook, adapted for Web-based delivery from an in-person intervention, was tested in a randomized controlled trial with 123 breast cancer survivors. Strategies for ensuring treatment fidelity were implemented and assessed. : The National Institutes of Health Behavior Change Consortium Treatment Fidelity Guidelines were relevant to establishing treatment fidelity for the Web-based intervention. : Web-based delivery of behavioral interventions is both a strength and a threat to treatment fidelity. Investigators must be cognizant of the elements of treatment fidelity and implement strategies to monitor and improve the reliability and validity of Web-based interventions.

Manualization of Occupational Therapy Interventions: Illustrations From the Pressure Ulcer Prevention Research Program

The manualization of a complex occupational therapy intervention is a crucial step in ensuring treatment fidelity for both clinical application and research purposes. Toward the latter end, intervention manuals are essential for ensuring trustworthiness and replicability of randomized controlled trials that aim to provide evidence of the effectiveness of occupational therapy. In this article, we review the literature on the process of intervention manualization. We then illustrate the prescribed steps through our experience in implementing the University of Southern California/Rancho Los Amigos National Rehabilitation Center's collaborative Pressure Ulcer Prevention Project. In this research program, qualitative research provided the initial foundation for manualization of a multifaceted occupational therapy intervention designed to reduce the incidence of medically serious pressure ulcers in adults with spinal cord injury.

P2-S4.04 Motivational interviewing is effective for reducing high risk sexual behaviour

BackgroundMotivational interviewing (MI) can be effective for behaviour change even when tailored to brief encounters. MI is focused on resolving the ambivalence that might prevent change. We have developed and...

The Clinical Application and Relevance of Resource-Oriented Principles in Music Therapy within an International Multicentre Study in Psychiatry

This article is based on an international randomised controlled trial (RCT) in psychiatry investigating the effects of music therapy on difficult to treat psychiatric clients who show a lack of motivation to attend therapy. Previous research has shown that music therapy can be an alternative therapeutic treatment for this client group and this RCT aimed to address this observation. The RCT was a collaboration between music therapists from different therapeutic cultures - Norway, Austria and Australia. Consequently, the music therapy provided was influenced by different training backgrounds. To provide a common methodological basis the therapists also focused on resource-oriented principles. These were especially developed for the study to ensure treatment fidelity, yet first of all have an important impact on the practical work. Five case vignettes depict how different therapists made use of these principles and in which ways these affected the therapeutic process. It will be shown how these principles serve as a methodological tool for reflecting the therapist's attitude towards the client. The relevance of the principles in terms of the establishment of a therapeutic relationship as well as the importance of a resource-oriented focus both in long-term and short-term therapeutic settings is highlighted. Finally, it can be assumed that resource-oriented principles exist at least implicitly throughout music therapeutic cultures and that these emphasise the relationship between therapist and client.

Role of technology in supporting quality control and treatment fidelity in a family caregiver clinical trial.

This article describes how a family caregiver lifestyle physical activity clinical trial uses research technology to enhance quality control and treatment fidelity. This trial uses a range of Internet, Blaise(®) Windows-based software and Echo Server technologies to support quality control issues, such as data collection, data entry, and study management advocated by the clinical trials literature, and to ensure treatment fidelity concerning intervention implementation (i.e., design, training, delivery, receipt, and enactment) as proposed by the National Institutes of Health Behavior Change Consortium. All research staff are trained to use these technologies. Strengths of this technological approach to support quality control and treatment fidelity include the comprehensive plan, involvement of all staff, and ability to maintain accurate and timely data. Limitations include the upfront time and costs for developing and testing these technological methods, and having support staff readily available to address technological issues if they occur.

Ensuring treatment fidelity in a multi‐site behavioral intervention study: implementing NIH behavior change consortium recommendations in the SMART trial

The Stories and Music for Adolescent/Young Adult Resilience during Transplant (SMART) study (R01NR008583; U10CA098543; U10CA095861) is an ongoing multi-site Children's Oncology Group randomized clinical trial testing the efficacy of a therapeutic music video intervention for adolescents/young adults (11-24 years of age) with cancer undergoing stem cell transplant. Treatment fidelity strategies from our trial are consistent with the National Institutes of Health (NIH) Behavior Change Consortium Treatment Fidelity Workgroup (BCC) recommendations and provide a successful working model for treatment fidelity implementation in a large, multi-site behavioral intervention study. In this paper, we summarize 20 specific treatment fidelity strategies used in the SMART trial and how these strategies correspond with NIH BCC recommendations in five specific areas: (1) study design, (2) training providers, (3) delivery of treatment, (4) receipt of treatment, and (5) enactment of treatment skills. Increased use and reporting of treatment fidelity procedures is essential in advancing the reliability and validity of behavioral intervention research. The SMART trial provides a strong model for the application of fidelity strategies to improve scientific findings and addresses the absence of published literature, illustrating the application of BCC recommendations in behavioral intervention studies.

Establishing Treatment Fidelity in a Coping and Communication Support Telephone Intervention for Aging Patients With Advanced Cancer and Their Family Caregivers

A randomized controlled trial of a nurse-delivered coping and communication support (CCS) intervention tailored to the preferences of middle-aged and older patients with advanced cancer and their family caregivers is tested for its value in improving outcomes for quality cancer care. An intervention study must be reliably delivered to estimate the accuracy of findings or make valid conclusions about the outcomes of research. The purpose of this article was to describe methodology for ensuring treatment fidelity in this patient-centered CCS intervention. Fidelity is maximized by ensuring that the CCS intervention is congruent with relevant theory, standardizing training and interventionist competence, and monitoring intervention delivery and documentation. We address unique challenges arising from using individualized interventions that preserve autonomy of the individual and are responsive to shifts in patients' needs and preferences over time. The challenge of nursing research on patient preference and coping communication requires both rigorous measurement of interventionist adherence to the intervention protocol and flexibility to allow for changing needs of patients and family caregivers.

Wirksamkeit und Wirkmechanismen von Psychotherapie bei der Behandlung der Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) bei Kindern und Erwachsenen

The multicentre network being funded in the context of the program of the German Federal Ministry of Education and Research (BMBF) on psychotherapy research is investigating effects and mechanisms of psychotherapy in the treatment of attention deficit hyperactivity disorder (ADHD) in children and adults. Single projects are focussing (1) on the investigation of the efficacy of psychotherapy, stimulant medication, a combination of both and a control condition for the treatment of ADHD in adults, (2) on the investigation of the enhancement of the efficacy of parent training for children's ADHD by a precedent treatment of ADHD in affected mothers and (3) on the study of associations between neurobiological markers (neuroimaging, genetic variations) and treatment outcome. In the clinical trials modern standards of psychotherapy research are taken into account (e.g. sample size based on power calculation, randomized controlled trial, use of treatment manuals, measures to ensure treatment fidelity, blind observer rating of outcome, intention to treat analysis). Results are supposed to strengthen the evidence base of the treatment of ADHD and to contribute to a better understanding of the mechanisms of therapeutic change. On the one hand our network reinforces the co-operation of general psychiatry and child and adolescent psychiatry in diagnosis and treatment of ADHD over the lifespan, on the other hand the association between clinical and fundamental research is strengthened.

Recovery, psychosis and psychiatry: research is better than rhetoric

Recovery, psychosis and psychiatry: research is better than rhetoric

Differential effects of experiential and problem-solving interventions in resolving marital conflict.

The present study compared the relative effectiveness of two interventions in the treatment of marital discord: a cognitive-behavioral intervention, teaching problemsolving skills, and an experiential intervention, focusing on emotional experiences underlying interaction patterns. Forty-five couples seeking therapy were randomly assigned to one of these treatments or to a wait-list control group. Each treatment was administered in eight sessions by six experienced therapists whose interventions were monitored and rated to ensure treatment fidelity. Results indicated that the perceived strength of the working alliance between couples and therapists and general therapist effectiveness were equivalent across treatment groups and that both treatment groups made significant gains over untreated controls on measures of goal attainment, marital adjustment, intimacy levels, and target complaint reduction. Furthermore, the effects of the emotionally focused treatment were superior to those of the problem-solving treatment on marital adjustment, intimacy, and target complaint level. At follow-up, marital adjustment scores in the emotionally focused group were still significantly higher than those in the problem-solving group.