Question for people familiar with counseling processes & fidelity to manualized protocol research

[summerbabe]

Seeing if anybody immersed in this space can point me towards some of the research on effectiveness of different training/teaching approaches with respect to manualized protocols (e.g., CBT for Chronic Pain) as well as specific treatments (DBT for BPD).

In particular, I have been wondering if there's any good research on effectiveness/efficacy of taking more rigid & more fidelity-focused approaches to teaching/introducing protocols to new therapists (e.g., not using a certain type of specific language in a protocol = not in fidelity).

So kind of a fluid intelligence/principle-based teaching approach versus crystalized intelligence/task-focused teaching approach to put the question differently? Thanks in advance!

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[cara susanna]

I don't know if this answers your question, but therapist fidelity to CPT has been demonstrated to be a VERY important predictor of outcomes in that therapy.

 

[summerbabe]

I don't know if this answers your question, but therapist fidelity to CPT has been demonstrated to be a VERY important predictor of outcomes in that therapy.

Yes! That's helpful and something I've heard before - I was wanting to immerse some in the literature to see how it's being measured, what is being found, and what types of questions are still unanswered or hard to answer via our research methods.

If you have any citations off the top or researchers within the CPT space who are doing this work specifically, I would love some directions to dive into.

 

[cara susanna]

Yes! That's helpful and something I've heard before - I was wanting to immerse some in the literature to see how it's being measured, what is being found, and what types of questions are still unanswered or hard to answer via our research methods.

If you have any citations off the top or researchers within the CPT space who are doing this work specifically, I would love some directions to dive into.

I was able to obtain a list! Here you go:

Farmer, C. C., Mitchell, K. S., Parker-Guilbert, K., & Galovski, T. E. (2017). Fidelity to the cognitive processing therapy protocol: Evaluation of critical elements. Behavior therapy, 48(2), 195-206.

Holder, N., Holliday, R., Williams, R., Mullen, K., & Surís, A. (2018). A preliminary examination of the role of psychotherapist fidelity on outcomes of cognitive processing therapy during an RCT for military sexual trauma-related PTSD. Cognitive behaviour therapy, 47(1), 76-89. tandfonline.com/doi/pdf/10.1080/16506073.2017.1357750

Marques, L., Valentine, S. E., Kaysen, D., Mackintosh, M. A., Dixon De Silva, L. E., Ahles, E. M., ... & Wiltsey-Stirman, S. (2019). Provider fidelity and modifications to cognitive processing therapy in a diverse community health clinic: Associations with clinical change. Journal of consulting and clinical psychology, 87(4), 357. 2019-14424-003.pdf (apa.org)

Keefe, J. R., Hernandez, S., Johanek, C., Landy, M. S., Sijercic, I., Shnaider, P., ... & Stirman, S. W. (2022). Competence in delivering Cognitive Processing Therapy and the therapeutic alliance both predict PTSD symptom outcomes. Behavior Therapy, 53(5), 763-775. https://doi.org/10.1016/j.beth.2021.12.003