The Children's Psychosocial Rehabilitation Treatment Adherence Measure: development and initial validation

This paper reports on two studies designed to develop and validate a treatment adherence measure for Children's Psychosocial Rehabilitation (CPSR)--a home- and community-based treatment for youth with serious emotional disturbance. In Study 1, we derived CPSR treatment adherence and differentiation criteria from a treatment manual and evaluated their content validity via structured feedback from practitioners. In study 2 we assessed the reliability and validity of the resultant CPSR Treatment Adherence Measure (CTAM) in a clinical sample of youth receiving CPSR (n = 11) or outpatient psychotherapy (n = 20). Results from Study 1 revealed strong agreement among practitioners regarding the validity of the proposed adherence criteria (ICC = .82). Results from Study 2 indicated the CTAM had good internal consistency (parent- and supervisor report α's = .86 & .91) and high inter-rater reliability (r = .87, P = .001) in this pilot sample. CTAM scores reliably distinguished between children receiving CPSR versus psychotherapy (z = -3.16, P = .002) and between CPSR interventionists with reputations for high- (n = 4) or low- (n = 7) adherence to the model (z = -2.47, P = .014). Findings indicate the CTAM is worthy of further development as a practice and research instrument.