Multisystemic therapy: Monitoring treatment fidelity

The challenges of specifying a complex and individualized treatment model a nd measuring fidelity thereto are described, using multisystemic therapy (M ST) as an example. Relations between therapist adherence to MST principles and instrumental and ultimate outcome variables are examined, as are relati ons between clinical supervision and therapist adherence. The findings prov ide modest support for the associations between MST adherence measures and instrumental and ultimate outcomes. Results also show that adherence can be altered when clinical supervision and adherence monitoring procedures are fortified. The modest associations between adherence measures and youth out comes argue for further refinement and validation of the MST adherence meas ure, especially in light of the well-established effectiveness of MST with challenging clinical populations and the increasing dissemination of MST pr ograms.