Implementation of a smoking cessation treatment integrity protocol: Treatment discriminability, potency and manual adherence

Testing manual adherence and treatment discriminability and potency have become increasingly important to ensuring the internal validity of treatment studies [Moncher, F.J., & Prinz, R.J., (1991). Treatment fidelity in outcome studies. Clinical Psychology Review, 11, 247–266.]. The objective of this study was therefore to implement the treatment integrity protocol based on the standardized framework proposed by Waltz, Addis, Koerner and Jacobson [Waltz, J., Addis, M.E., Koerner, K., & Jacobson, N.S., (1993). Testing the integrity of a psychotherapy protocol: Assessment of adherence and competence. Journal of Consulting and Clinical Psychology, 61, 620–630.] to assess manual adherence and treatment discriminability and potency in a smoking cessation trial. Audio recordings of 15, 6-week smoking cessation groups were randomly selected from a sample of 31 groups and were rated for treatment integrity. Findings offered partial evidence for manual adherence which did not differ according to treatment condition. Analyses also indicated that the treatments were potent yet not highly discriminable across conditions. Despite some challenges, this preliminary application of the Waltz et al. [Waltz, J., Addis, M.E., Koerner, K., & Jacobson, N.S., (1993). Testing the integrity of a psychotherapy protocol: Assessment of adherence and competence. Journal of Consulting and Clinical Psychology, 61, 620–630.] protocol indicated that it is a promising and flexible tool that may be used to examine different aspects of treatment integrity.