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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

The Development of the Treatment Integrity - Efficient Scale for Cognitive Behavioral Treatment for Youth Anxiety (TIES-CBT-YA)

Smith, Meghan 01 January 2017 (has links)
Brief, easy to use, psychometrically strong (i.e., pragmatic) instruments are needed to support implementation research; the current study assessed whether it was possible to develop a pragmatic observational treatment integrity instrument and reduce the amount of time coders spend making treatment integrity ratings (while maintaining score validity) of therapists delivering two protocols of individual cognitive-behavioral treatment (ICBT) for youth anxiety in research and practice settings. The 12-item instrument was derived from four observational treatment integrity instruments with promising score reliability and validity that assess adherence, competence, differentiation, and alliance. A sample of 106 youths (M age = 10.12, SD = 1.81, ages 7-14; 42.50% Female; 69.80% Caucasian) received one of three treatments to address anxiety: standard ICBT in a research setting (n = 51) or standard ICBT (n = 22), modular ICBT (n = 16), or usual care (UC; n = 17) in practice settings. Four coders independently coded five- and 15- minute segments sampled from four sessions from each client (N = 756 sessions). Ten percent of sessions were double-coded for reliability purposes. Reliability, sensitivity to change, construct validity, and predictive validity from the two segments were compared to full session treatment integrity scores independently archived in a study assessing the same clients. Across five- and 15-minute segments, the instrument produced promising score reliability and convergent validity evidence for adherence, competence, and alliance items (items intended for inclusion in ICBT for youth anxiety; M ICCs = .62, SD = .17; M rs = .58, SD = .12) and poor score reliability and validity evidence for differentiation items (items intended for inclusion in other treatment domains; M ICCs = .21, SD = .28; M rs = .27, SD = .25). This study met its primary aim, to develop an instrument that can be coded in less than 20 minutes while maintaining evidence of score validity. Researchers interested in developing such instruments can use this study design as a roadmap. Future research should investigate whether psychometric findings replicate across samples, why certain items (e.g., client-centered interventions) did not evidence score validity, and how this type of instrument can inform EBT training.

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