Treatment integrity in interventions for children diagnosed with DSM-5 disorders

Abstract

Treatment (also known as, or) refers to the reliable and accurate implementation of an intervention. Treatment integrity (TI) is a term that refers to how the treatment which is actually administered is similar to the theoretical and procedural components of the intended treatment model (Dusenbury, Brannigan, Falco, & Hansen, 2003; Nezu & Nezu, 2008; Reed & Codding, 2011). Failing to control for treatment integrity can result in several issues (Livanis, Benvenuto, Mertturk, & Hanthorn, 2013). First, if a treatment is not implemented with fidelity, clinicians cannot reliably evaluate the effects of the independent variable upon the dependent variable (Cooper, Heron, & Heward, 2007; Kazdin, 2011). In these instances, the intervention takes on multiple “lives”-one which exists on paper and one which is actually implemented-both of which may be similar to one another but are not exactly the same (Livanis & Mercer, in press). Second, there is the potential lack of improvement among clients. When interventions are implemented with higher rates of treatment integrity, there is a stronger association with positive treatment outcomes (DiGennaro, Martens, & Kleinman, 2007; DiGennaro, Martens, & McIntyre, 2005; Erhardt, Barnett, Lentz, Stollar, & Raifin, 1996; Hogue et al., 2008). When well-designed interventions are implemented correctly, there tends to be positive effects on clients.