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Assessing the Fidelity of an Affirmative Cognitive Behavioral Group Intervention
Shelley L Craig1, Rachael V Pascoe1, Gio Iacono2
1Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada.
Research on Social Work Practice
|April 10, 2023
Summary
This study developed a fidelity process for the AFFIRM intervention, ensuring high adherence in therapy for LGBTQ+ individuals. Findings improve the effective delivery of affirmative mental health services.
Area of Science:
- Clinical Psychology
- Social Work Research
- LGBTQ+ Mental Health
Background:
- Intervention research requires high implementation fidelity for reliable results.
- Lesbian, gay, bisexual, transgender, queer, and sexual and gender diverse (LGBTQ+) populations face unique mental health challenges.
- Affirmative therapeutic approaches are crucial for LGBTQ+ well-being.
Purpose of the Study:
- To systematically develop and evaluate a fidelity process for the AFFIRM intervention.
- To ensure consistent and effective delivery of an evidence-based, affirmative cognitive behavioral therapy group intervention for LGBTQ+ youth and adults.
- To support implementation fidelity in intervention research with LGBTQ+ populations.
Main Methods:
- Development of the AFFIRM fidelity checklist for assessing clinician adherence.
- Coding of 151 audio-recorded group sessions by four trained raters.
- Quantitative analysis of adherence scores and inter-rater reliability, alongside qualitative thematic analysis of session recordings.
Main Results:
- High mean fidelity score (84.13, SD = 12.50) indicating strong clinician adherence.
- Substantial inter-rater reliability (81%) suggesting consistent coding.
- Qualitative analysis identified facilitators of high fidelity and barriers to implementation.
Conclusions:
- The developed fidelity process is effective in measuring and supporting intervention delivery.
- Findings inform clinical training and coaching to enhance the implementation of social work interventions for LGBTQ+ individuals in community settings.
- The study highlights challenges and effective strategies for implementing interventions with sexual and gender diverse populations.
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