Assessing the Fidelity of an Affirmative Cognitive Behavioral Group Intervention. (May 2023)

• Record Type: Journal Article
• Authors: Craig, Shelley L.; Pascoe, Rachael V.; Iacono, Gio; Pang, Nelson; Pearson, Ali
• Is Part Of: Research on social work practice. Volume 33:Number 4(2023)
• Page Start: 375
• Page End: 389
• Publication Date: 2023-05
• Subjects: LGBTQ+ -- implementation fidelity -- affirmative practice -- social work intervention research; Social service -- Periodicals; 361.3205
• DOI: 10.1177/10497315221110865
• Languages: English
• ISSNs: 1049-7315

Abstract

Purpose: Support implementation fidelity in intervention research with lesbian, gay, bisexual, transgender, queer, and sexual and gender diverse (LGBTQ+) populations, this study explores the systematic development of a fidelity process for AFFIRM, an evidence-based, affirmative cognitive behavioral therapy group intervention for LGBTQ+ youth and adults. Method: As part of a clinical trial, the AFFIRM fidelity checklist was designed to assess clinician adherence. A total of 151 audio-recorded group sessions were coded by four trained raters. Results: Adherence was high with a mean fidelity score of 84.13 ( SD = 12.50). Inter-rater reliability was 81%, suggesting substantial agreement. Qualitative thematic analysis of low-rated sessions identified deviations from the manual and difficulties in group facilitation, while high-rated sessions specified affirmative and effective clinical responses. Discussion: Findings were integrated into clinical training and coaching. The fidelity process provides insights into the challenges of implementing social work interventions effectively with LGBTQ+ populations in community settings.