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Assessing Fidelity of Treatment Delivery in Group and Individual 12-Step Facilitation.

Journal of Substance Abuse Treatment 2012;44(2):169-176. [doi: 10.1016/ju.jsat.2012.07.003]

Barbara K. Campbell, PhD (Oregon Health & Science University, WS Node), Jennifer Knapp Manuel, PhD (University of California, San Francisco, WS Node), Sarah Turcotte Manser, MA (University of California, San Francisco, WS Node), K. Michelle Peavy, PhD (Evergreen Treatment Services, PN Node), Julija Stelmokas, MS (Pacific University, WS Node), Dennis McCarty, PhD (Oregon Health & Science University, WS Node), Joseph R. Guydish, PhD (University of California, San Francisco, WS Node).

Twelve step facilitation (TSF) is an emerging, empirically supported treatment, the study of which will be strengthened by rigorous fidelity assessment. This report describes the development, reliability, and concurrent validity of the Twelve Step Facilitation Adherence Competence Empathy Scale (TSF ACES), a comprehensive fidelity rating scale for group and individual TSF treatment developed for the National Drug Abuse Treatment Clinical Trials Network ancillary study "Organizational and Practitioner Influences on Implementation of STAGE-12" (CTN-0031-A-3). Independent raters used TSF ACES to rate treatment delivery fidelity of 966 (97% of total) TSF group and individual sessions. TSF ACES summary measures assessed therapist treatment adherence, competence, proscribed behaviors, empathy, and overall session performance. TSF ACES showed fair to good overall reliability; weighted kappa coefficients for 59 co-rated sessions ranged from .31 to 1.00, with a mean of .69. Reliability ratings for session summary measures were good to excellent (.69–.91). Internal consistency for the instrument was variable (.47–.71). Relationships of the TSF ACES summary measures with each other, as well as relationships of the summary measures with a measure of therapeutic alliance, provided support for concurrent and convergent validity. Fidelity instruments such as the TSF ACES can be used in clinical implementation to train and supervise counselor adherence and skill. Implications and future directions for the use of the measure in clinical trials and community treatment implementation are discussed.

The administration manual for the TSF-ACES, which includes a copy of the scale itself, can be found here:

(Article (Peer-Reviewed), PDF, English, 2012)

Keywords: Behavior therapy | Clinical supervision | Counselors | Fidelity of implementation | Group therapy | Screening and assessment instruments | Stimulant abuse | Twelve-Step Facilitation Adherence Competence Empathy Scale (TSF ACES) | Twelve-Step Programs | Journal of Substance Abuse Treatment (journal)

Document No: 904, PMID: 22944595, PMCID: PMC3515700.

Submitted by Joseph Guydish, PhD (WS Node), 9/5/2012.

Campbell, Barbara K. search mail
Guydish, Joseph R. search mail
Manser, Sarah Turcotte search
Manual, Jennifer Knapp search
McCarty, Dennis search mail
Peavy, K. Michelle search mail
Stelmokas, Julija search
NIDA-CTN-0031-A-3 search www
Western States search www

Supported by a grant from the National Institute on Drug Abuse to the University of Washington Alcohol and Drug Abuse Institute.
The materials on this site have neither been created nor reviewed by NIDA.
Updated 9/2014 --