Developing a manual for identifying interventions in psychotherapy to measure treatment adherence in research

Abstract: This article describes the process of developing a manual of therapeutic interventions of ten different modalities. With this manual, independent raters can identify the therapeutic interventions occurring in a therapy session. In research, this is called the control of treatment adherence. The article also presents some results shown by using this manual. A surprising finding was that treatment fidelity was rather low in all treatment modalities. Therapists in all modalities were identified as using between 4.7% and 32.5% of interventions specific to their school of psychotherapy. Nonspecific interventions ranged between 51.4% and 73.2% of all interventions identified. Between 14.8% and 24.8% were identified as interventions from other treatment modalities. Keywords: psychotherapy research, naturalistic design, treatment adherence, Manual of therapeutic interventions, Gestalt therapy, specific and non-specific interventions