ABSTRACT Measuring therapists’ adherence to treatment manuals is recommended for evaluating treatment integrity, yet ways to do this are poorly defined, time consuming, and costly. The aims of the study were to develop a Therapy Component Checklist (TCC) to measure adherence to manualised CBT; to test its application in research and clinical practice; to determine its validity; and consider its cost benefits. We conducted a randomised trial in 230 people with cancer evaluating effectiveness of CBT for depression. In this, therapists delivered manualised treatment. Experts agreed on key components of therapy and therapists were asked to record these after therapy sessions by ticking a TCC. Inter-rater reliability was tested using an independent rater. Therapists delivered 543 CBT sessions. TCCs were completed in 293, of which 39 were assessed by the independent rater. Self-reported TCC data suggested close adherence to the manual. Prevalence-adjusted and bias-adjusted kappa scores suggested substantial agreement, (>0.60) in 38 out of 46 items. Self-rating of adherence saved around £96 per rating. In conclusion the TCC provides a quick and cost effective way of evaluating the components of therapy delivered. This approach could be applied to other psychological treatments and may help with linking therapeutic interventions with outcome.

中文翻译：

---

一种衡量心理治疗中治疗依从性的实用方法

摘要 建议测量治疗师对治疗手册的依从性来评估治疗的完整性，但这样做的方法定义不明确、耗时且成本高。该研究的目的是制定治疗成分清单 (TCC) 来衡量对手动 CBT 的依从性；测试其在研究和临床实践中的应用；确定其有效性；并考虑其成本效益。我们在 230 名癌症患者中进行了一项随机试验，评估 CBT 治疗抑郁症的有效性。在这方面，治疗师提供了手动治疗。专家们就治疗的关键组成部分达成一致，并要求治疗师在治疗后通过勾选 TCC 来记录这些内容。使用独立评估者测试评估者间的可靠性。治疗师提供了 543 次 CBT 课程。TCC 于 293 年完成，其中 39 项由独立评估员评估。自我报告的 TCC 数据表明严格遵守手册。在 46 项中的 38 项中，流行率调整和偏差调整的 kappa 分数表明基本一致（>0.60）。依从性的自我评级为每个评级节省了大约 96 英镑。总之，TCC 提供了一种快速且具有成本效益的方式来评估所提供的治疗成分。这种方法可以应用于其他心理治疗，并可能有助于将治疗干预与结果联系起来。总之，TCC 提供了一种快速且具有成本效益的方式来评估所提供的治疗成分。这种方法可以应用于其他心理治疗，并可能有助于将治疗干预与结果联系起来。总之，TCC 提供了一种快速且具有成本效益的方式来评估所提供的治疗成分。这种方法可以应用于其他心理治疗，并可能有助于将治疗干预与结果联系起来。