Pilot Trial of Online Measurement Training and Feedback in Family Therapy for Adolescent Behavior Problems

J Clin Child Adolesc Psychol. 2023 Nov-Dec;52(6):850-865. doi: 10.1080/15374416.2022.2051529. Epub 2022 Apr 6.

Abstract

Objective: Pragmatic procedures for sustaining high-fidelity delivery of evidence-based interventions are needed to support implementation in usual care. This study tested an online therapist training system, featuring observational coder training and self-report fidelity feedback, to promote self-report acumen and routine use of family therapy (FT) techniques for adolescent behavior problems.

Method: Therapists (N = 84) from nine substance use and mental health treatment sites reported on 185 adolescent clients. Therapists submitted baseline data on FT technique use with clients, completed a workshop introducing the 32-week training system, and were randomly assigned by site to Core Training versus Core Training + Consultation. Core Training included a therapist coder training course (didactic instruction and mock session coding exercises in 13 FT techniques) and fidelity feedback procedures depicting therapist-report data on FT use. Consultation convened therapists and supervisors for one-hour monthly sessions with an external FT expert. During the 32 weeks of training, therapists submitted self-report data on FT use along with companion session audiotapes subsequently coded by observational raters.

Results: Therapist self-report reliability and accuracy both increased substantially during training. Observers reported no increase over time in FT use; therapists self-reported a decrease in FT use, likely an artifact of their improved self-report accuracy. Consultation did not enhance therapist self-report acumen or increase FT use.

Conclusions: Online training methods that improve therapist-report reliability and accuracy for FT use may confer important advantages for treatment planning and fidelity monitoring. More intensive and/or different training interventions appear needed to increase routine FT delivery.

Trial registration: ClinicalTrials.gov NCT03342872.

Publication types

  • Observational Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adolescent Behavior*
  • Family Therapy*
  • Feedback
  • Humans
  • Pilot Projects
  • Reproducibility of Results

Associated data

  • ClinicalTrials.gov/NCT03342872