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Making a Case for Treatment Integrity as a Psychosocial Treatment Quality Indicator for Youth Mental Health Care


Address correspondence to Bryce D. McLeod, Virginia Commonwealth University, Department of Psychology, 806 West Franklin Street, PO Box 842018, Richmond, VA 23284-2018. E-mail:


Measures of treatment integrity are needed to advance clinical research in general and are viewed as particularly relevant for dissemination and implementation research. Although some efforts to develop such measures are underway, a conceptual and methodological framework will help guide these efforts. The purpose of this article is to demonstrate how frameworks adapted from the psychosocial treatment, therapy process, healthcare, and business literatures can be used to address this gap. We propose that components of treatment integrity (i.e., adherence, differentiation, competence, alliance, client involvement) pulled from the treatment technology and process literatures can be used as quality indicators of treatment implementation and thereby guide quality improvement efforts in practice settings. Further, we discuss how treatment integrity indices can be used in feedback systems that utilize benchmarking to expedite the process of translating evidence-based practices to service settings.