TY - JOUR
T1 - Assessing fidelity of treatment delivery in group and individual 12-step facilitation
AU - Campbell, Barbara K.
AU - Manuel, Jennifer K.
AU - Manser, Sarah Turcotte
AU - Peavy, K. Michelle
AU - Stelmokas, Julija
AU - McCarty, Dennis
AU - Guydish, Joseph R.
N1 - Funding Information:
This work was supported by NIDA ( R01 DA025600 ), by the Western States research node of NIDA CTN ( U10 DA015815 ) and by the NIDA San Francisco Treatment Research Center ( P50 DA009253 ). Jennifer Manuel is currently supported by a NIDA training grant T32 DA007250 . We are grateful to Dennis Donovan, Dennis Daley and the STAGE-12 study team for their help in providing access to STAGE-12 adherence scales, digital recordings of treatment sessions and other study data, as well as to staff at all the participating treatment sites. In addition, we appreciate the dedication and professionalism of our fidelity raters, who worked tirelessly to complete all ratings, and the formatting assistance of Lindsay Docto.
PY - 2013/2
Y1 - 2013/2
N2 - Twelve step facilitation (TSF) is an emerging, empirically supported treatment, the study of which will be strengthened by rigorous fidelity assessment. This report describes the development, reliability and concurrent validity of the Twelve Step Facilitation Adherence Competence Empathy Scale (TSF ACES), a comprehensive fidelity rating scale for group and individual TSF treatment developed for the National Drug Abuse Treatment Clinical Trials Network study, Stimulant Abuser Groups to Engage in 12-Step. Independent raters used TSF ACES to rate treatment delivery fidelity of 966 (97% of total) TSF group and individual sessions. TSF ACES summary measures assessed therapist treatment adherence, competence, proscribed behaviors, empathy and overall session performance. TSF ACES showed fair to good overall reliability; weighted kappa coefficients for 59 co-rated sessions ranged from .31 to 1.00, with a mean of .69. Reliability ratings for session summary measures were good to excellent (.69-.91). Internal consistency for the instrument was variable (.47-.71). Relationships of the TSF ACES summary measures with each other, as well as relationships of the summary measures with a measure of therapeutic alliance provided support for concurrent and convergent validity. Implications and future directions for the use of TSF ACES in clinical trials and community treatment implementation are discussed.
AB - Twelve step facilitation (TSF) is an emerging, empirically supported treatment, the study of which will be strengthened by rigorous fidelity assessment. This report describes the development, reliability and concurrent validity of the Twelve Step Facilitation Adherence Competence Empathy Scale (TSF ACES), a comprehensive fidelity rating scale for group and individual TSF treatment developed for the National Drug Abuse Treatment Clinical Trials Network study, Stimulant Abuser Groups to Engage in 12-Step. Independent raters used TSF ACES to rate treatment delivery fidelity of 966 (97% of total) TSF group and individual sessions. TSF ACES summary measures assessed therapist treatment adherence, competence, proscribed behaviors, empathy and overall session performance. TSF ACES showed fair to good overall reliability; weighted kappa coefficients for 59 co-rated sessions ranged from .31 to 1.00, with a mean of .69. Reliability ratings for session summary measures were good to excellent (.69-.91). Internal consistency for the instrument was variable (.47-.71). Relationships of the TSF ACES summary measures with each other, as well as relationships of the summary measures with a measure of therapeutic alliance provided support for concurrent and convergent validity. Implications and future directions for the use of TSF ACES in clinical trials and community treatment implementation are discussed.
KW - 12-Step facilitation
KW - Coding system
KW - Treatment fidelity
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U2 - 10.1016/j.jsat.2012.07.003
DO - 10.1016/j.jsat.2012.07.003
M3 - Article
C2 - 22944595
AN - SCOPUS:84870706469
SN - 0740-5472
VL - 44
SP - 169
EP - 176
JO - Journal of Substance Abuse Treatment
JF - Journal of Substance Abuse Treatment
IS - 2
ER -