Traditionally, treatment adherence has been measured in outcome studies by highly trained, independent raters who code audio- or video-taped treatment sessions to understand therapists’ adherence to preestablished treatment session components. Unfortunately, this method of assessing treatment adherence is time-, labor-, and cost-intensive, and does not translate well to community settings. This study compared expert-coded behavior observations, therapist and caregiver report of therapists’ adherence to nine teaching technique items assessed in treatment sessions using Alternatives for Families: A Cognitive Behavioral Therapy (AF-CBT) to determine whether other raters (outside of traditional expert coders) could effectively and accurately measure therapist adherence. A total of 533 therapy sessions were coded across experts (n = 2), therapists (n = 20), and caregivers (n = 42). Outcomes indicated strikingly different ratings across all reporters suggesting that therapist and caregiver reports may be supplement to, but not substitute for, observer ratings.

中文翻译：

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在循证治疗中衡量对关键教学技术的依从性：看护者、治疗师和行为观察评级的比较

传统上，治疗依从性是由训练有素的独立评估者在结果研究中衡量的，他们对音频或录像治疗课程进行编码，以了解治疗师对预先确定的治疗课程组成部分的依从性。不幸的是，这种评估治疗依从性的方法是时间、劳动力和成本密集型的​​，并且不能很好地转化为社区环境。本研究比较了专家编码的行为观察、治疗师和护理人员报告，即治疗师在治疗过程中使用家庭替代方案：认知行为疗法 (AF-CBT) 评估的九项教学技术项目的坚持情况，以确定其他评估者（传统专家之外的编码员）可以有效和准确地衡量治疗师的依从性。总共有 533 个治疗疗程由专家 (n = 2) 编码，治疗师（n = 20）和护理人员（n = 42）。结果表明所有报告者的评级截然不同，这表明治疗师和护理人员的报告可能是对观察者评级的补充，但不能替代。