Therapist and observer ratings of therapist fidelity to a family-based prevention model

Alisa Jill Singer, Fordham University


This study involved three interrelated parts. In Part 1, level of fidelity was examined for a family-based prevention program called Multidimensional Family Prevention (MDFP). One hundred and ten videotaped sessions of MDFP, 57 sessions of Multidimensional Family Treatment (MDFT), and 32 sessions of Cognitive-Behavioral Treatment (CBT) were coded for adherence by observers using the Therapist Behavior Rating Scale-2nd version (TBRS-2). Dependent t tests demonstrated that therapists adhered to MDFP generally, but violated adherence by spending too much time with the adolescents alone. F tests and contrasts showed that MDFP was differentiable from CBT but not from MDFT. In Part 2, the relationship between observer and therapist ratings of fidelity to MDFP was explored. All MDFP therapists rated their own adherence after each session using the Therapist Self-Report Checklist (TSRC). Adherence ratings from the TSRC were compared with observer adherence ratings from the TBRS-2. Intraclass correlation coefficients found moderate to strong concordances, suggesting that observers and therapists shared a similar perspective of adherence. Finally in Part 3, observer and therapist ratings of some aspects of adherence were compared with objective ratings. Forty videotaped MDFP sessions were randomly selected from the 110 that were rated by the observers. These 40 sessions were objectively assessed for some aspects of adherence. Intraclass correlation coefficients showed high concordances between therapist and objective ratings and observer and objective ratings. Observers were not found to agree more strongly with objective ratings than therapists with objective ratings. The results of this study suggest that a parameter-based system of adherence can be developed for a family-based prevention program and that therapists can adhere. It also indicates that therapists may be able to be relied upon to provide ratings of their own adherence.

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Recommended Citation

Singer, Alisa Jill, "Therapist and observer ratings of therapist fidelity to a family-based prevention model" (2001). ETD Collection for Fordham University. AAI3022799.