Adherence and Competence of Therapists to a Stress Reduction Program Based on Acceptance and Commitment Therapy

Abstract

Treatment Integrity (IT) is a concept that refers to the assessment of competence and adherence to a treatment or intervention. Adherence and competence can be defined respectively as how much the therapist followed the proposed protocol or theoretical approach and how skillful he was in his performance. Despite the importance of this data, the assessment of IT is still often omitted in scientific publications. The objective of this article was to evaluate adherence and competence of therapists in an intervention of eight meetings to reduce stress in university students based on Acceptance and Commitment Therapy (ACT). The intervention sessions were recorded and each encounter selected for the study was evaluated by three ACT expert judges. For data analysis, the Fleiss kappa coefficient and the Friedman test were used. The results indicated good agreement between the judges. The therapists showed excellent adherence to the program (minimum 77,8%) and good levels of competence (2.7 to 3 on a scale of 0 to 3). Regarding the psychological flexibility processes, the levels of adherence were higher for the processes focused on each encounter. Future studies with larger samples are suggested that allow different analyzes to understand the IT phenomenon.