Peavy K Michelle, Guydish Joseph, Manuel Jennifer K, Campbell Barbara K, Lisha Nadra, Le Thao, Delucchi Kevin, Garrett Sharon
University of Washington, Alcohol & Drug Abuse Institute, Seattle, WA 98105; Evergreen Treatment Services, Seattle, WA 98134.
University of California, San Francisco, Philip R. Lee Institute for Health Policy Studies, San Francisco, CA 94118.
J Subst Abuse Treat. 2014 Sep;47(3):222-8. doi: 10.1016/j.jsat.2014.05.008. Epub 2014 Jun 10.
This study investigated the correspondence among four groups of raters on adherence to STAGE-12, a manualized 12-step facilitation (TSF) group and individual treatment targeting stimulant abuse. The four rater groups included the study therapists, supervisors, study-related ("TSF expert") raters, and non-project related ("external") raters. Results indicated that external raters rated most critically mean adherence - the mean of all the adherence items - and global performance. External raters also demonstrated the highest degree of reliability with the designated expert. Therapists rated their own adherence lower, on average, than did supervisors and TSF expert raters, but therapist ratings also had the poorest reliability. Findings highlight the challenges in developing practical, but effective methods of fidelity monitoring for evidence based practice in clinical settings. Recommendations based on study findings are provided.
本研究调查了四组评估者在遵循STAGE-12方面的一致性，STAGE-12是一种针对兴奋剂滥用的手册化12步促进（TSF）团体及个体治疗方法。这四组评估者包括研究治疗师、督导、与研究相关的（“TSF专家”）评估者以及与项目无关的（“外部”）评估者。结果表明，外部评估者对平均依从性（所有依从性项目的平均值）和整体表现的评分最为严格。外部评估者与指定专家之间的可靠性程度也最高。治疗师对自己依从性的平均评分低于督导和TSF专家评估者，但治疗师的评分可靠性也是最差的。研究结果凸显了在临床环境中为循证实践开发实用但有效的保真度监测方法所面临的挑战。文中还基于研究结果给出了建议。
