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Fidelity versus flexibility in the implementation of psychotherapies: Time to move on

Fonagy, P; Luyten, P; (2019) Fidelity versus flexibility in the implementation of psychotherapies: Time to move on. World Psychiatry : official journal of the World Psychiatric Association (WPA) (In press).

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Abstract

In psychotherapy, treatment fidelity refers to the extent to which treatments are delivered as intended, and is considered to encompass adherence (the extent to which pre-specified interventions are used) and competence (the skill with which they are implemented). Treatment fidelity is typically assumed to be positively related to outcome. This assumption rests on the drug metaphor – that there is a positive relationship between the “dose” of the “active ingredients” in any given treatment and the outcome. For instance, the extent to which therapists use specific theory-derived techniques and interventions, such as challenging automatic thoughts in cognitive-behavioural therapy or working with the transference in psychodynamic psychotherapy, should be directly related to better outcomes.

Type: Article
Title: Fidelity versus flexibility in the implementation of psychotherapies: Time to move on
Publisher version: https://onlinelibrary.wiley.com/loi/20515545
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
URI: http://discovery.ucl.ac.uk/id/eprint/10067194
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