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Self-Coding of Fidelity as a Potential Active Ingredient of Consultation to Improve Clinicians’ Fidelity

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Abstract

A key goal for implementation science is the identification of evidence-based consultation protocols and the active ingredients within these protocols that drive clinician behavior change. The current study examined clinicians’ self-coding of fidelity as a potential active ingredient of consultation for the Attachment and Biobehavioral Catch-up (ABC) intervention. It also examined two other potential predictors of clinician fidelity in response to consultation: dosage of consultation and working alliance. Twenty-nine clinicians (97% female, 62% White, M age = 34 years) participated in a year of weekly fidelity-focused ABC consultation sessions, for which clinicians self-coded fidelity and received consultant feedback on both their coding and their fidelity. Data from the ABC fidelity measure were available for 1067 sessions coded by consultants, and clinicians’ self-coding accuracy was calculated from 1044 sessions coded by both clinicians and consultants. Alliance was measured with the Working Alliance Inventory—Trainee and Supervisor Versions. The study was observational, and fidelity and self-coding accuracy were modeled across time using hierarchical linear modeling. Clinicians’ ABC fidelity, as well as their self-coding accuracy, increased over the course of consultation. Clinicians’ self-coding accuracy predicted their initial fidelity and growth in fidelity. Working alliance was also linked to fidelity and self-coding accuracy. These results suggest that clinician self-coding should be further examined as an active ingredient of consultation. The study has important implications for the design of consultation procedures and fidelity assessments.

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Data Availability

In order to maximize sample size in the current study, the dataset used in Caron and Dozier (2019) was included in the current study, representing 6 of the 29 clinicians. Preliminary data from the current study were published as a dissertation (Caron, 2017), but have not previously been published in a peer-reviewed journal.

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Acknowledgements

We would like to thank the parent coaches and consultants who participated in this study.

Funding

This study was supported by the National Institutes of Health under Grants R01 MH052135, R01 MH074374, and R01 MH084135.

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Authors and Affiliations

  1. Department of Psychological Science, Fitchburg State University, 160 Pearl St., Fitchburg, MA, 01420, USA

    EB Caron

  2. Department of Psychological and Brain Sciences, University of Delaware, 108 Wolf Hall, Newark, DE, 19716, USA

    Mary Dozier

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  1. EB Caron
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Correspondence to EB Caron.

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This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Institutional Review Board of the University of Delaware.

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Caron, E., Dozier, M. Self-Coding of Fidelity as a Potential Active Ingredient of Consultation to Improve Clinicians’ Fidelity. Adm Policy Ment Health 49, 237–254 (2022). https://doi.org/10.1007/s10488-021-01160-4

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