Therapist-report measures of evidence-based interventions have enormous potential utility as quality indicators in routine care; yet, few such tools have shown strong psychometric properties. This study describes reliability and validity characteristics of a therapist-report measure of family therapy techniques for treating adolescent conduct and substance use problems: Inventory of Therapy Techniques for Core Elements of Family Therapy (ITT-CEFT). Study participants included 31 staff therapists treating 68 adolescent clients in eight community-based mental health and substance use clinics. Therapists submitted ITT-CEFT checklists and companion audio recordings for 189 sessions. The ITT-CEFT contains 13 techniques identified as core elements of three manualized family therapy models that are empirically supported for the target group. Therapists also reported on their use of three motivational interventions, and independent observers coded the submitted recordings. ITT-CEFT factor validity was shown via confirmatory factor analyses of the tool’s theoretical structure. Derived modules were: Family Engagement (four items; Cronbach’s α = .72); Relational Orientation (five items; α = .74); and Interactional Change (four items; α = .66). Concurrent validity analyses showed fair-to-excellent therapist reliability compared to observer ratings (ICCs range .64–.75); they showed moderate therapist accuracy compared to observer mean scores, reflecting a tendency to overestimate delivery of the techniques. Discriminant validity analyses showed tool differentiation from motivational interventions. Results offer provisional evidence for the feasibility of using the therapist-report ITT-CEFT to anchor quality procedures for family therapy interventions in real-world settings.
Administration and Policy in Mental Health and Mental Health Services Research. 2021. https://doi.org/10.1007/s10488-021-01164-0
Aaron Hogue, Ph.D.
Senior Vice President, Research and Clinical Science / Family and Adolescent Clinical Technology and Science (FACTS)
Molly Bobek, L.C.S.W.
Vice President, Family and Adolescent Clinical Technology and Science (FACTS)
Nicole Porter, Ph.D.
Project Director for the PCORI-funded Primary Connections for Youth and Families [PCYF] clinical trial
Alexandra MacLean, M.A.
Director, Clinical Training and Research Operations, FACTS
Craig E. Henderson
Sam Houston State University