Measures to Monitor PLL Adherence

What Measures are Used?

Treatment fidelity is defined as the extent to which treatment was delivered as intended and the therapists followed the treatment plan as intended (Moncher & Prinz, 1991).

The treatment fidelity protocol is based upon triangulating multiple data sources. The use of triangulation provides investigators with assurance that clinicians are using the treatment model as written. According to Moncher and Prinz (1991), triangulation is rarely used but absolutely necessary if treatment fidelity is to be addressed.

To address the issue of treatment fidelity and triangulation, the following measures are used for both PLL Group Therapy and PLL Family Therapy components:

1 - Interpersonal Process Recall (IPR) - (Therapist Adherence Measure)

Brief Description: Interpersonal Process Recall (IPR) is a 7-item measure to evaluate the therapist's adherence to the PLL Model as reported by the PLL Therapists and/or the PLL Supervisor. The PLL therapist plays back videotaped moments during particular moments in the therapy session. This method is referred to by such names as stimulated recall, playback, videotape inquiry and the retrospection method.
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2 - Monthly PLL Report - (Therapist Adherence Measure)

Brief Description: The PLL Report is a software application that calculates in "real time" the following measures: (a) attrition rates; (b) graduation rates (c) the number of clients that started the program, how many dropped out, and in how many sessions. This PLL Report is shown weekly to the therapists and has the benefit of illustrating how each individual PLL therapist is doing in using the PLL Model to get the family engaged and then graduating them from both group and family therapy.
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3 - Group Protocol Checklist - (Therapist Adherence Measure)

Brief Description: The Group Protocol Checklist is used to assess treatment fidelity adherence to the PLL group therapy model. Each of the six classes has a checklist of key concepts specific to that class that were either covered or not covered by the therapist. In addition, therapists use a Likert scale to measure how closely they followed the Leader's Guide.
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4 - Family Therapy Protocol Checklist - (Therapist Adherence Measure)

Brief Description: The Family Therapy Protocol Checklist is a 9-item PLL therapist self-report checklist scale of adherence to the PLL Family Therapy Model. After each family therapy session, the therapist will fill out each of the 9 areas that assess competency of the major tenets of the PLL Family Therapy Model: (a) which of the 7-steps of the model are currently addressed; (b) what page of the Survival Kit are you on with the family; (c) what toxic seed is causing the symptom; (d) what are the top two dysfunctional undercurrents and missing healthy counterparts; (e) what stage of readiness are the clients and therapist on; (f) what strategic directives will be used to fill in the missing healthy undercurrent; (g) filling out the eco-map to determine the village; (h) an "unstuckness" checklist; (I) the need for live supervision if stuck.
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