Measuring fidelity of brief cognitive behavior therapy for insomnia: Development, reliability and validity.

Autor: Cross WF; University of Rochester Medical Center, USA; Center of Excellence for Suicide Prevention, USA. Electronic address: Wendi_Cross@URMC.Rochester.edu., McCarten J; Center of Excellence for Suicide Prevention, USA. Electronic address: Janet.McCarten@va.gov., Funderburk JS; University of Rochester Medical Center, USA; Center for Integrated Healthcare for the U.S. Department of Veterans Affairs, USA. Electronic address: Jennifer.Funderburk@va.gov., Crean HF; University of Rochester Medical Center, USA; Center of Excellence for Suicide Prevention, USA. Electronic address: Hugh.Crean@URMC.Rochester.edu., Lockman J; University of Alabama Birmingham, USA. Electronic address: Jjdlockman@uabmc.edu., Titus CE; Center of Excellence for Suicide Prevention, USA. Electronic address: Caitlin.Titus@va.gov., Pigeon WR; University of Rochester Medical Center, USA; Center of Excellence for Suicide Prevention, USA. Electronic address: Wilfred.Pigeon2@va.gov.
Jazyk: angličtina
Zdroj: Evaluation and program planning [Eval Program Plann] 2024 Dec 08; Vol. 109, pp. 102531. Date of Electronic Publication: 2024 Dec 08.
DOI: 10.1016/j.evalprogplan.2024.102531
Abstrakt: Purpose: Measuring fidelity is critical in program evaluations to assess how implementation influences outcomes. Implementer fidelity is comprised of adherence to the treatment content and competence of treatment delivery. Cognitive behavioral therapy for insomnia (CBT-I) is well-established and empirically supported with variants such as brief CBTi (bCBTi) showing promise in reducing both insomnia and depression. The impact of therapist fidelity on treatment outcomes is unknown in part because reliable measures have not been available. We developed measures of therapist fidelity for bCBT-i and assessed the impact of fidelity in the context of a pilot study with veterans in primary care.
Methods/results: Audio recordings from 23 participants (78 % male) were coded. Therapist adherence measures were created for each session along with a single measure of therapist competence. Inter-rater reliability was established and predictive validity was determined. For total adherence, inter-rater reliability was excellent across sessions (ICC =.73 -.80). The competence measure showed good reliability across all sessions (ICC =.57) and was internally consistent (Cronbach's alpha =.75). There was only 10 % of shared variance between adherence and competence. All of the fidelity measures demonstrated associations with outcomes in the predicted direction; therapist adherence was significantly associated with decreased depression.
(Copyright © 2024. Published by Elsevier Ltd.)
Databáze: MEDLINE
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