Use of clients' self-reports to monitor Project Liberty clinicians' fidelity to a cognitive-behavioral intervention

Objective: This study examined outcomes associated with clinicians' fidelity to key elements of a cognitive-behavioral treatment intervention developed for Project Liberty's enhanced services counseling program. Methods: In telephone interviews 60 individuals reported how often their clinicians provided six components considered central to the intervention by the intervention developers. Respondents received services at sites where some (25 to 50 percent) or all clinicians had received training in the intervention. Results: Compared with respondents who received services where only some clinicians had received training (N=19), those who received services where all clinicians had received training (N=41) were significantly more likely to report that their clinicians applied techniques central to the intervention (p <.01). Additionally, those who received services from sites where all clinicians were trained were significantly more likely to report that they had been given homework (p <.05). Conclusions: Brief questions to service recipients are a useful and cost-effective way to monitor intervention fidelity.