Improving therapist fidelity during implementation of evidence-based practices: Incredible years program

Area of Science:

• Child Psychology
• Clinical Psychology
• Evidence-Based Practices

Background:

• Therapist training is crucial for effective delivery of evidence-based interventions.
• Ensuring fidelity to treatment models is essential for positive patient outcomes.
• The Incredible Years parenting program is designed for children at high risk of conduct problems.

Purpose of the Study:

• To evaluate the benefits of adding ongoing feedback, coaching, and consultation to initial therapist training workshops.
• To enhance the fidelity of evidence-based practice delivery.
• Specifically for the Incredible Years parenting program.

Main Methods:

• A randomized controlled trial compared a standard three-day workshop with an enhanced model including ongoing coaching and consultation.
• Fifty-six therapists from ten California community mental health organizations participated.
• The enhanced model incorporated expert coaching, video review, and consultation for therapists and supervisors.

Main Results:

• Therapists in the enhanced training group showed significantly greater strengths in practical support, collaboration, knowledge, and skill in mediating vignettes.
• Overall fidelity was rated above 3 on a 5-point scale in seven of eight measured domains across both conditions.
• The enhanced training model demonstrated superior results in key areas of therapist performance.

Conclusions:

• Ongoing expert coaching and consultation beyond standard training significantly enhance therapists' skills.
• This enhanced approach improves adherence to evidence-based models like the Incredible Years program.
• Investments in continuous professional development are vital for effective mental health service delivery.