Psychology

Testing the integrity of a psychotherapy protocol: assessment of adherence and competence

Jennifer Waltz, University of Washington
Michael E. Addis, University of Washington
Kelly Koerner, University of Washington
Neil S. Jacobson, University of Washington

Abstract

Manipulation checks should be used in psychotherapy trials to confirm that therapists followed the treatment manuals and performed the therapy competently. This article is a review of some strategies that have been used to document treatment integrity; also, their limitations are discussed here. Recommendations for improving these checks are presented. Specific guidelines are offered regarding when and how to assess both therapist adherence to treatment protocols and competence.