A general system for evaluating therapist adherence and competence in psychotherapy research in the addictions

The Yale Adherence and Competence Scale (YACS) is a general system for rati ng therapist adherence and competence in delivering behavioral treatments f or substance use disorders. The system includes three scales measuring 'gen eral' aspects of drug abuse treatment (assessment, general support, goals o f treatment), as well as three scales measuring critical elements of three treatments that are frequently implemented as control or comparison treatme nts in clinical research in the addictions (clinical management (CM), twelv e step facilitation (TSF), and cognitive behavioral therapy (CBT)). Validat ion of the YACS using data from a randomized clinical trial indicated that the scales have excellent reliability, factor structure, concurrent and dis criminant validity. Correlations between adherence and competence scores wi thin scales were in the moderate range, indicating independence (and thus n onredundancy) of these dimensions. Strategies for using the YACS in both ps ychotherapy and pharmacotherapy research in the addictions are described. ( C) 2000 Elsevier Science Ireland Ltd. All rights reserved.