Abstract

Purpose To capitalize on investments in evidence-based practice implementation, technology is needed to scale up fidelity assessment. Stakeholder feedback may facilitate adoption of such tools. This study examined mental health providers’ perceptions of an automated fidelity-rating tool for Cognitive Behavioral Therapy (CBT). Methods We administered online surveys before and after focus groups that included therapists (n= 18) and clinical leadership (n= 12) from community mental health programs implementing CBT. Discussions centered on supervision practices followed by feedback about the fidelity tool. Transcripts were analyzed using a grounded theory approach. Results Initial perceptions of acceptability, appropriateness, and feasibility of automated CBT fidelity tools were positive and increased after introduction of the tool, including significant increases in ratings of acceptability and appropriateness. Standard supervision was described as collaboratively guided, either scheduled or spontaneous, and focused on clinical content, self-care, and documentation. Participants highlighted the tool’s utility for supervision, training, and professional growth, but questioned its ability to rate skills related to rapport, cultural diversity, and non-verbal communication. Concerns were raised about client and therapist privacy, and the impact of low scores on therapist confidence. Desired features included labeling of interventions used and transparency about how fidelity scores related to specific point in the session. Opportunities for asynchronous, remote, and targeted supervision were of particular value. Conclusions Automated fidelity assessment …
Purpose

Methods

Results

Conclusions

Date

2020

Authors

Torrey A Creed, Rebecca Oziel, Danielle Reich, Margaret Thomas, Sydne O'Connor, Zac E Imel, Tad Hirsch, Shrikanth Narayanan, David C Atkins