![]() ![]() Benchmarking studies typically focus on critical areas such as client retention, model implementation, and clinical outcomes ( Hunsley & Lee, 2007). A main focus was examining individual differences among community therapists in fidelity and outcome performance using statistical process control, a method that has enormous utility for quality assurance purposes in routine care.Benchmarking the Implementation of Evidence-Based Treatments in Usual Careīenchmarking is a method for assessing whether therapists delivering evidence-based treatments (EBTs) in routine clinical settings can approximate performance standards set by research-funded clinicians in controlled trials ( Spilka & Dobson, 2015). ![]() Benchmarks included both treatment fidelity, in the form of adherence to core family therapy techniques for this population and treatment outcomes, in the form of six-month reductions in delinquent acts, externalizing symptoms, and internalizing symptoms. This study evaluated whether community therapists delivering family therapy for adolescent behavior problems in usual care reached performance benchmarks established by research-trained therapists implementing manualized family-based treatments. Recommendations are made for developing therapist-report fidelity measures and utilizing statistical process control methods to diagnose therapist differences and enhance quality assurance procedures. Caveats for interpreting therapist performance data, given the small sample size, are described. ![]() Community therapists also demonstrated a high degree of performance uniformity: Each one approximated the fidelity benchmark, and only two produced relatively weak outcomes on any of the client change indicators. Regarding change in client functioning at six-month follow-up, community therapists were equivalent to the benchmark for internalizing symptoms and superior for externalizing symptoms and delinquent acts. Results showed that community therapists surpassed the fidelity benchmark for core family therapy techniques established by research therapists during a controlled trial. Therapists provided self-report data on adherence to core family therapy techniques these scores were inflation-adjusted based on concordance with observer reports. Clients were treated by 13 therapists in one community mental health clinic that delivered family therapy as the routine standard of care. The study contained N = 38 adolescents (50% male mean age 15 years) whose self-reported race/ethnicity was Hispanic (74%), African American (11%), multiracial (11%), and other (4%). This study evaluated whether community therapists delivering family therapy for adolescent behavior problems in usual care achieved performance benchmarks established in controlled trials for treatment fidelity and outcomes, with particular focus on individual differences in therapist performance. ![]()
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