Department of Psychological Science, Fitchburg State University, 160 Pearl St., Fitchburg, MA, 01420, USA.
Department of Psychological and Brain Sciences, University of Delaware, 108 Wolf Hall, Newark, DE, 19716, USA.
Adm Policy Ment Health. 2022 Mar;49(2):237-254. doi: 10.1007/s10488-021-01160-4. Epub 2021 Sep 9.
A key goal for implementation science is the identification of evidence-based consultation protocols and the active ingredients within these protocols that drive clinician behavior change. The current study examined clinicians' self-coding of fidelity as a potential active ingredient of consultation for the Attachment and Biobehavioral Catch-up (ABC) intervention. It also examined two other potential predictors of clinician fidelity in response to consultation: dosage of consultation and working alliance. Twenty-nine clinicians (97% female, 62% White, M age = 34 years) participated in a year of weekly fidelity-focused ABC consultation sessions, for which clinicians self-coded fidelity and received consultant feedback on both their coding and their fidelity. Data from the ABC fidelity measure were available for 1067 sessions coded by consultants, and clinicians' self-coding accuracy was calculated from 1044 sessions coded by both clinicians and consultants. Alliance was measured with the Working Alliance Inventory-Trainee and Supervisor Versions. The study was observational, and fidelity and self-coding accuracy were modeled across time using hierarchical linear modeling. Clinicians' ABC fidelity, as well as their self-coding accuracy, increased over the course of consultation. Clinicians' self-coding accuracy predicted their initial fidelity and growth in fidelity. Working alliance was also linked to fidelity and self-coding accuracy. These results suggest that clinician self-coding should be further examined as an active ingredient of consultation. The study has important implications for the design of consultation procedures and fidelity assessments.
实施科学的一个关键目标是确定基于证据的咨询协议，以及这些协议中推动临床医生行为改变的有效成分。本研究考察了临床医生自我编码的保真度作为依恋和生物行为追赶（ABC）干预咨询的潜在有效成分。它还研究了咨询中临床医生保真度的另外两个潜在预测因素：咨询剂量和工作联盟。29 名临床医生（97%为女性，62%为白人，平均年龄为 34 岁）参加了为期一年的每周一次的以保真度为重点的 ABC 咨询会议，临床医生在这些会议上自我编码保真度，并就他们的编码和保真度获得顾问反馈。顾问对 1067 次会议进行了 ABC 保真度评估，数据可用，临床医生对 1044 次会议进行了自我编码和顾问编码。工作联盟通过工作联盟量表-学员和主管版本进行衡量。该研究是观察性的，使用分层线性建模对保真度和自我编码准确性进行了跨时间建模。临床医生的 ABC 保真度以及他们的自我编码准确性在咨询过程中逐渐提高。临床医生的自我编码准确性预测了他们最初的保真度和保真度的增长。工作联盟也与保真度和自我编码准确性相关。这些结果表明，应该进一步研究临床医生的自我编码作为咨询的有效成分。该研究对咨询程序和保真度评估的设计具有重要意义。
