The impact of pay-for-performance on therapists' intentions to deliver high-quality treatment

This article examined the extent to which assignment to a pay-for-performance (P4P) experimental condition impacted therapists' intentions to deliver high-quality treatment and the extent to which therapists' intentions could be explained by the theory of planned behavior. Data were collected from 95 therapists who agreed to participate in a P4P experiment related to their implementation of an evidence-based treatment (EBT) for adolescents with substance use problems. Relative to those in the control condition, therapists in the P4P condition reported significantly greater intentions to achieve monthly competence (B = 1.41, p < .001) and deliver a targeted threshold level of treatment to clients (B = 1.31, p < .001). In addition, therapists' intentions could be partially explained by the theory of planned behavior. Meta-analyses have found intentions to be one of the best predictors of behavior; thus, these findings provide initial support for using P4P approaches as a method of increasing the quality of substance use treatment.