Treatment integrity and therapeutic change: Issues and research recommendations.

TLDR

Treatment integrity, defined as the fidelity of implementation, is crucial for outcome research but studies linking it to therapeutic change have yielded inconsistent results, possibly due to assessment and design confounds. This paper critiques current methods for assessing the link between treatment integrity and outcomes and proposes future research strategies, including controlling confounds, experimental manipulation, and novel assessment techniques.

Abstract

One of the most important aspects of treatment outcome research is establishing treatment integrity. Integrity of the treatment refers to the degree to which treatment is implemented as intended. Research examining the relationship between treatment integrity and therapeutic change has produced conflicting results. However, assessment, design strategies, and the possible confound of integrity with other variables may explain the inconsistency in findings. This paper elaborates the limitations of existing strategies for evaluating the relationship between treatment integrity and outcome. Recommendations for future research include controlling possible confounding variables, experimentally manipulating treatment integrity, and using novel assessment and evaluation strategies.