Treatment integrity in psychotherapy research: Analysis of the studies and examination of the associated factors.
Abstract
Treatment integrity refers to the degree to which an intervention is delivered as intended. Two studies evaluated the adequacy of treatment integrity procedures (including establishing, assessing, evaluating, and reporting integrity; therapist treatment adherence; and therapist competence) implemented in psychotherapy research, as well as predictors of their implementation. Randomized controlled trials of psychosocial interventions published in 6 influential psychological and psychiatric journals were reviewed and coded for treatment integrity implementation. Results indicate that investigations that systematically addressed treatment integrity procedures are virtually absent in the literature. Treatment integrity was adequately addressed for only 3.50% of the evaluated psychosocial interventions. Journal of publication and treatment approach predicted integrity implementation. Skill-building treatments (e.g., cognitive-behavioral) as compared with non-skill-building interventions (e.g., psychodynamic, nondirective counseling) were implemented with higher attention to integrity procedures. Guidelines for implementation of treatment integrity procedures need to be reevaluated.
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The study did not obtain or evaluate recordings of sessions to verify clinicians' competence and compliance with treatment manuals.
“Moreover, we did not include obtain and evaluate recordings of sessions to verify clinicians’ competence and compliance with the treatment manuals, verification that is strongly recommended and would enhance the internal validity of the trial (Perepletchikova, Treat, & Kazdin, 2007).”
From Mindfulness and cognitive-behavioral interventions for chronic pain: Differential effects on daily pain reactivity and stress reactivity (2015) · cites this paper as Perepletchikova, Treat, & Kazdin, 2007
Only 3.5% of psychotherapy randomized clinical trials use adequate treatment integrity procedures.
“only 3.5% of psychotherapy randomized clinical trials use adequate treatment integrity procedures.9”
From Quantifying the association between psychotherapy content and clinical outcomes using deep learning (2020) · cites this paper as [9]
The Improving Access to Psychological Therapies (IAPT) program in England includes no objective measure of treatment integrity for CBT.
“Despite its widespread use, the Improving Access to Psychological Therapies (IAPT) program in England includes no objective measure of treatment integrity for CBT”
From Quantifying the association between psychotherapy content and clinical outcomes using deep learning (2020) · cites this paper as [9]
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References 52 · Cited by 533
- Authors
- Perepletchikova, F., Treat, T. A., & Kazdin, A. E.
- Affiliations
- Yale University (US)
- Venue
- Journal of Consulting and Clinical Psychology
- Published
- 2007
- Volume
- 75
- Issue
- 6
- Pages
- 829-841
- ISSN
- 0022-006X (ISSN-L)
- 1939-2117
- OpenAlex
- W1993183309
- Cited by
- 533
- References
- 52
- Citations by year
- 2026: 7 · 2025: 14 · 2024: 14 · 2023: 23 · 2022: 30 · 2021: 59 · 2020: 21 · 2019: 45 · 2018: 34 · 2017: 23 · 2016: 34 · 2015: 30 · 2014: 39 · 2013: 45 · 2012: 32
- FWCI
- 16.31
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Consulting and Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Robert M. Leylan Dissertation Fellowship
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Keywords
- implementation fidelity, psychotherapy research, therapist adherence, therapist competence, psychosocial interventions, randomized controlled trials, cognitive behavioral therapy, psychodynamic psychotherapy, non-directive counseling, research reporting practices
- MeSH terms
- Humans, Psychotherapy, Treatment Outcome, Guidelines as Topic
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