This study describes a multimethod

This study describes a multimethod evaluation of treatment fidelity to the family therapy (FT) approach
demonstrated by front-line therapists in a community behavioral health clinic that utilized FT as its
routine standard of care. Study cases (N = 50) were adolescents with conduct and/or substance use
problems randomly assigned to routine family therapy (RFT) or to a treatment-as-usual clinic not aligned
with the FT approach (TAU). Observational analyses showed that RFT therapists consistently achieved a
level of adherence to core FT techniques comparable to the adherence benchmark established during an
efficacy trial of a research-based FT. Analyses of therapist-report measures found that compared to TAU,
RFT demonstrated strong adherence to FT and differentiation from three other evidence-based practices:
cognitive-behavioral therapy, motivational interviewing, and drug counseling. Implications for rigorous
fidelity assessments of evidence-based practices in usual care settings are discussed.