Development and Initial Validation of a Client-Rated MET-CBT Adherence Measure

• Published in: Substance Abuse: Research and Treatment Vol. 2012; no. 2012; pp. 85 - 94
• Main Authors: Ulaszek, Wendy R, Lin, Hsiu-Ju, Frisman, Linda K, Sampl, Susan, Godley, Susan Harrington, Steinberg-Gallucci, Karen L, Kamon, Jody L, O'Hagan-Lynch, Margaret
• Format: Journal Article
• Language: English
• Published: London, England Libertas Academica 01.01.2012; SAGE Publishing; SAGE Publications; Sage Publications Ltd. (UK); Sage Publications Ltd
• Subjects: Cognitive therapy; Examinations; Methods; Motivation; Original Research; Patient outcomes; Substance abuse treatment; Surveys; Validity; fidelity; client ratings; MET-CBT; implementation
• ISSN: 1178-2218; 1178-2218
• DOI: 10.4137/SART.S9896

Traditional mechanisms for rating adherence or fidelity are labor-intensive. We developed and validated a tool to rate adherence to Motivational Enhancement Therapy–-Cognitive Behavioral Treatment (MET-CBT) through anonymous client surveys. The instrument was used to survey clients in 3 methadone programs over 2 waves. Explanatory and Confirmatory Factor Analyses were used to establish construct validity for both MET and CBT. Internal consistency based on Cronbach's alpha was within adequate range (α > 0.70) for all but 2 of the subscales in one of the samples. Consensus between clients’ ratings (rwg(j) scores) were in the range of 0.6 and higher, indicating a moderate to strong degree of agreement among clients’ ratings of the same counselor. These results suggest that client surveys could be used to measure adherence to MET-CBT for quality monitoring that is more objective than counselor self-report and less resource-intensive than supervisor review of taped sessions. However, additional work is needed to develop this scale.