Date of Award




Document Type


Degree Name

Doctor of Philosophy (PhD)


Department of Psychology


Clinical Psychology

Content Description

1 online resource (v, 79 pages) : forms.

Dissertation/Thesis Chair

James F Boswell

Committee Members

Julia M Hormes, Drew A Anderson


dissemination, eating disorders, evidence-based practice, implementation, treatment fidelity, Eating disorders, Evidence-based psychotherapy, Medical personnel, Self-evaluation

Subject Categories

Clinical Psychology | Psychology


Objective: Fidelity monitoring is a vital component of successful evidence-based practice implementation in routine treatment settings. However, resource-intensiveness and low clinician buy-in pose barriers to traditional observer-report monitoring, highlighting a need to explore the practical utility of self-report approaches. This study used a mixed-methods approach to (a) develop a self-report fidelity measure of a transdiagnostic evidence-based protocol in a residential eating disorders treatment center; (b) tailor the measure for optimal accuracy, acceptability, and ease of use; and (c) assess measure validity via convergence with observer ratings. Methods: N = 10 clinicians participated in cognitive interviewing to refine an initial draft of the measure. N = 15 clinicians used the finalized measure to self-rate fidelity in routine therapy sessions. Correlational analyses assessed measure internal consistency and reliability as well as convergence between self-report and observer ratings for a sample of N = 51 sessions. Results: Cognitive interviews indicated a need for expanded instructions, clearer language, and more specific rating anchors. The final measure demonstrated good internal consistency and reliability and convergence with observer-report data on categorical adherence ratings and mean quality ratings. Dimensional and item-level ratings showed less agreement. Conclusion: The study generated a usable self-report measure that has been adopted into routine practice with minimal disruption. Analyses show preliminary support for use of the measure as a snapshot of overall fidelity and a supplement to observer ratings at the study site.