Trial Report Assessing adherence and competence in delivering telehealth group cognitive behavioral stress management, 2024, May, Antoni et al

https://psycnet.apa.org/record/2024-82068-001

Citation
May, M., Ream, M., Milrad, S. F., Perdomo, D. M., Czaja, S. J., Jutagir, D. R., Hall, D. L., Klimas, N., & Antoni, M. H. (2024). Assessing adherence and competence in delivering telehealth group cognitive behavioral stress management. International Journal of Stress Management. Advance online publication. https://doi.org/10.1037/str0000324
Abstract

Treatment fidelity, or consistent therapist adherence and competence in intervention delivery, is an important component of intervention design and dissemination.

Yet few systems have been developed to assess fidelity in telepsychology and related remotely delivered intervention venues.

We sought to modify and evaluate a fidelity coding approach for a videoconference-delivered group cognitive behavioral stress management (CBSM) intervention.

Although validated rating systems for treatment fidelity exist, they typically focus on individual therapy and are inappropriate for the structure of group stress management interventions.

We modified the RAND Corporation Fidelity Coding Guide, which was initially designed for audio-recorded group cognitive behavioral therapy, for applicability to videotaped sessions of CBSM.

Two raters applied the resulting CBSM Coding Guide to 146 session recordings taken from a CBSM trial for persons with chronic fatigue syndrome and their partners, with 40% of sessions double-coded.

Reliability for eight adherence items and 15 competence items was moderate overall (average κw = .751) with 20 of the 23 items demonstrating at least moderate interrater reliability (i.e., κw > .600).

Three items that did not meet this cutoff would benefit from more extensive operationalization and rater training.

Our adapted system provides a means of assessing adherence and competence variables to validate the delivery of CBSM and of associating these with positive treatment outcomes to isolate the “active ingredients” of CBSM.

Further, the successful modification and application of the RAND Corporation Fidelity Coding Guide support the adaptation of this system for a diverse range of remotely delivered cognitive behavioral group therapies. (PsycInfo Database Record (c) 2024 APA, all rights reserved)

 

But on what basis is it determined that adherence is a good thing here? Other than beliefs and professional validity, i.e. it's not considered good when clients drop off therapy?

Because when someone is extremely thirsty and they drink 3 glasses of water, you could say that they adhered to the 3-water glass therapy. But if they're only a bit thirsty and drink half of one, but that's all they need, then that's all they need. There are no "active ingredients" here anymore than in a glass of homeopathic water, so the concept is irrelevant.

Except here this isn't like water and how it relates to thirst, there is zero basis that any of this treatment is of any use for anything, it's all just labels on empty bottles, or even worse piss bottles. To patients anyway, it's clearly useful to clinicians and bad researchers.

And the title says "for stress management", but it was on CFS patients and their partners. So this is more like a 3-sand glass therapy for thirst, trying to see if people will swallow the whole 3 glasses of sand, without bothering that swallowing sand is not of any use for thirst.

Psychological research has actually gotten worse since the days of the Stanford prison experiment, because the old woowoo is now coated in pseudoscientific language and irrelevant 'performance' metrics, even though it's just as empty as it ever was. The glass of sand is basically empty, but they'll serve it for you to quench your thirst, according to them anyway.

 

how to monetise the sick without actually doing anything worthwhile . Welcome to the extremes of capitalism everything and everyone has to become a source of profit.