ArticleJournal of consulting and clinical psychology2019
Provider fidelity and modifications to cognitive processing therapy in a diverse community health clinic: Associations with clinical change.
Article in Journal of consulting and clinical psychology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers.
What it found
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The trial behind it
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Who cites it
47 citing papers in PubMed, 107 citations in OpenAlex.
- The Content of Usual Clinical Care for Youth with Primary Anxiety Problems.Administration and policy in mental health · 2025Trial
- Capitalizing on natural language processing (NLP) to automate the evaluation of coach implementation fidelity in guided digital cognitive-behavioral therapy (GdCBT).Psychological medicine · 2025Trial
- Cost-effectiveness of train-the-trainer versus expert consultation training models for implementing interpersonal psychotherapy in college mental health settings: evidence from a national cluster randomized trial.Implementation science : IS · 2024Trial
- Exploring the Association between Individual-Level Attributes and Fidelity to a Vocational Rehabilitation Intervention within a Randomised Controlled Trial.International journal of environmental research and public health · 2023Trial
- Is adherence to dialectic behaviour therapy for post-traumatic stress disorder (PTSD) and cognitive processing therapy related to treatment outcome in PTSD after childhood abuse?European journal of psychotraumatology · 2023Trial
- Does treatment specific-, disorder specific- or general therapeutic competence predict symptom reduction in posttraumatic stress disorder?European journal of psychotraumatology · 2023Trial
- Scales for assessing therapeutic adherence and competence in dialectical behaviour therapy for PTSD: development and analysis of psychometric properties.European journal of psychotraumatology · 2022Trial
- Development and proof-of-concept of a treatment target recommendation algorithm in the context of cognitive processing therapy.European journal of psychotraumatology · 2026Article
- Characterizing clinical and counseling psychology graduate students' perceptions of evidence-based treatment usability and training.Psychological services · 2026Article
- Article
- Impact of social risk factors on TF-CBT engagement and strategies to mitigate the impact: A qualitative analysis.PLOS mental health · 2026Article
- Using machine learning to increase access to and engagement with trauma-focused interventions for posttraumatic stress disorder.The British journal of clinical psychology · 2025Review
- A Novel Approach to Research Synthesis with the Distillation and Matching Model: Application to the Prevention of Youth Social, Emotional, and Behavioral Problems.Prevention science : the official journal of the Society for Prevention Research · 2025Article
- Measuring fidelity to manualised peer support for people with severe mental health conditions: development and psychometric evaluation of the UPSIDES fidelity scale.BMC psychiatry · 2024Article
- Marketing mental health services: a mixed-methods analysis of racially and ethnically diverse college students' engagement with and perspectives on U.S. university mental health clinics' websites.BMC health services research · 2024Article
- Strategies for Implementing GlobalConsent to Prevent Sexual Violence in University Men (SCALE): Study Protocol for a National Implementation Trial.Research square · 2024Article
- Article
- Provider Adherence to Modular Cognitive Behavioral Therapy for Children and Adolescents.Administration and policy in mental health · 2024Article
- The assessment of therapist responsiveness in psychotherapy research: a systematic review.Research in psychotherapy (Milano) · 2024Article
- Incorporating Community Perspectives to Inform the Scaling-Out of an Evidence-Based Executive Functioning Intervention from Schools to Community Mental Health Settings.Evidence-based practice in child and adolescent mental health · 2024Article
Corrections and comments
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Authors and funding
10 authors at 7 institutions in 1 country.
Funding
Abstract
objectiveThe purpose of this study is to examine associations between therapist adherence, competence, and modifications of an evidence-based protocol (EBP) delivered in routine clinical care and client outcomes.
methodData were derived from a NIMH-funded implementation-effectiveness hybrid study of Cognitive Processing Therapy (CPT) for PTSD in a diverse community health center. Providers (n = 19) treated clients (n = 58) as part of their routine clinical care. Clients completed the PCL-S and PHQ-9 at baseline, after each CPT session, and posttreatment. CPT sessions were rated for treatment fidelity and therapist modifications.
resultsOverall, therapist adherence was high, although it decreased across sessions suggesting potential drift. Therapist competence ratings varied widely. Therapists made on average 1.6 fidelity-consistent and 0.4 fidelity-inconsistent modifications per session. Results show that higher numbers of fidelity-consistent modifications were associated with larger reductions in posttraumatic stress and depressive symptoms. High adherence ratings were associated with greater reductions in depressive symptoms, whereas higher competence ratings were associated with greater reduction in posttraumatic stress symptoms.
conclusionsThe results highlight the importance of differentially assessing therapist adherence, competence, and modifications to EBP in usual care settings. The findings also suggest that effective EBP delivery in routine care may require minor adaptations to meet client needs, consistent with previous studies. Greater attention to fidelity and adaptation can enhance training so providers can tailor while retaining core components of the intervention. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.