Objective: Pragmatic procedures for sustaining high-fidelity delivery of evidence-based interventions are needed to support implementation in usual care. This study tested an online therapist training system, featuring observational coder training and self-report fidelity feedback, to promote self-report acumen and routine use of family therapy (FT) techniques for adolescent behavior problems.
Method: Therapists (N = 84) from nine substance use and mental health treatment sites reported on 185 adolescent clients. Therapists submitted baseline data on FT technique use with clients, completed a workshop introducing the 32-week training system, and were randomly assigned by site to Core Training versus Core Training + Consultation. Core Training included a therapist coder training course (didactic instruction and mock session coding exercises in 13 FT techniques) and fidelity feedback procedures depicting therapist-report data on FT use. Consultation convened therapists and supervisors for one-hour monthly sessions with an external FT expert. During the 32 weeks of training, therapists submitted self-report data on FT use along with companion session audiotapes subsequently coded by observational raters.
Results: Therapist self-report reliability and accuracy both increased substantially during training. Observers reported no increase over time in FT use; therapists self-reported a decrease in FT use, likely an artifact of their improved self-report accuracy. Consultation did not enhance therapist self report acumen or increase FT use.
Conclusions: Online training methods that improve therapist-report reliability and accuracy for
FT use may confer important advantages for treatment planning and fidelity monitoring. More
intensive and/or different training interventions appear needed to increase routine FT
Journal of Clinical Child & Adolescent Psychology. 2022 April doi: 10.1080/15374416.2022.2051529
Aaron Hogue, Ph.D.
Vice President and Director of Family and Adolescent Clinical Technology & Science
Alexandra MacLean, M.A.
Manager, National Support Technical Assistance Center (NFSTAC)
Molly Bobek, L.C.S.W.
Associate Vice President, Family and Adolescent Clinical Technology and Science (FACTS)
Nicole Porter, M.A.
Senior Research Associate, Family and Adolescent Clinical Technology & Science (FACTS)