Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA.
Child and Adolescent Services Research Center, San Diego, CA, USA.
Adm Policy Ment Health. 2021 Jan;48(1):155-170. doi: 10.1007/s10488-020-01054-x.
Pragmatic measures of therapist delivery of evidence-based practice (EBP) are critical to assessing the impact of large-scale, multiple EBP implementation efforts. As an initial step in the development of pragmatic measurement, the current study examined the concordance between therapist and observer ratings of items assessing delivery of EBP strategies considered essential for common child EBP targets. Possible EBP-, session-, and therapist-levels factors associated with concordance were also explored. Therapists and independent observers rated the extensiveness of therapist (n = 103) EBP strategy delivery in 680 community psychotherapy sessions in which six EBPs were used. Concordance between therapist- and observer-report of the extensiveness of therapist EBP strategy use was at least fair (ICC ≥ .40) for approximately half of the items. Greater therapist-observer concordance was observed in sessions where a structured EBP was delivered and in sessions where therapists reported being able to carry out planned activities. Findings highlighted conditions that may improve or hinder therapists' ability to report on their own EBP strategy delivery in a way that is consistent with independent observers. These results can help inform the development of pragmatic therapist-report measures of EBP strategy delivery and implementation efforts more broadly.
评估大规模、多循证实践（EBP）实施工作的影响，治疗师提供 EBP 的实用措施至关重要。作为实用测量开发的初始步骤，本研究检查了评估 EBP 策略提供的项目的治疗师和观察者评分之间的一致性，这些策略被认为是常见儿童 EBP 目标的必要策略。还探讨了可能与一致性相关的 EBP、会话和治疗师水平因素。治疗师和独立观察者评估了 680 次社区心理治疗会话中治疗师（n=103）EBP 策略实施的全面性，其中使用了六种 EBP。治疗师和观察者报告的治疗师 EBP 策略使用的全面性之间的一致性至少为适度（ICC≥.40），对于大约一半的项目。在实施结构化 EBP 的会话和治疗师报告能够执行计划活动的会话中，观察到了更大的治疗师-观察者一致性。研究结果强调了可能改善或阻碍治疗师以与独立观察者一致的方式报告自己 EBP 策略实施情况的条件。这些结果可以帮助为更广泛的 EBP 策略实施和实施工作制定实用的治疗师报告措施提供信息。
