Research Article

Maintaining Treatment Fidelity of Mindfulness-Based Relapse Prevention Intervention for Alcohol Dependence: A Randomized Controlled Trial Experience

Table 3

Therapist adherence and competence across the intervention sessions and cohorts, as measured by the modified MBRP-AC scale.

OverallSession 1Session 2Session 3Session 4Session 5Session 6Session 7Session 8

Therapist adherence

(A) Key Treatment Components
mean ± SD 0.9 ± 0.10 1.0 ± 0.0 1.0 ± 0.1 1.0 ± 0.0 0.9 ± 0.1 0.8 ± 0.1 1.0 ± 0.0 0.8 ± 0.1 1.0 ± 0.1 
 C1–10: score for a given session in the assessed cohort C1: 0.9 ± 0.1 
C2: 1.0 ± 0.0 
C3: 1.0 ± 0.0
C4: 0.9 ± 0.1 
C5: 0.9 ± 0.1 
C6: 0.9 ± 0.1 
C7: 0.9 ± 0.1 
C8: 0.9 ± 0.1 
C9: 0.9 ± 0.2  
C10: 0.9 ± 0.1
C1: 1.0 
C3: 1.0 
C5: 1.0 
C8: 1.0 
C10: 1.0
C1: 0.9 
C5: 0.9 
C9: 1.0 
C10: 1.0
C1: 1.0 
C5: 1.0 
C7: 1.0 
C10: 1.0
C1: 0.9 
C2: 1.0 
C4: 0.9 
C5: 0.9 
C6: 1.0 
C10: 0.9
C1: 0.8 
C5: 0.9 
C8: 0.9 
C10: 0.9
C1: 1.0 
C4: 1.0 
C5: 1.0 
C10: 1.0
C1: 0.7 
C5: 0.8 
C6: 0.8 
C9: 0.7 
C10: 0.9
C2: 1.0 
C3: 1.0 
C7: 0.9

(B) Discussion of Key Concepts
mean ± SD  2.8 ± 0.4 2.8 ± 0.3 2.9 ± 0.3 3.0 ± 0.0 2.9 ± 0.1 3.0 ± 0.0 2.9 ± 0.1 2.9 ± 0.3 2.2 ± 0.9 
 C1–10: score for a given session in the assessed cohort C1: 2.9 ± 0.1 
C2: 2.1 ± 1.2 
C3: 2.3 ± 0.0 
C4: 2.8 ± 0.2 
C5: 2.9 ± 0.3 
C6: 3.0 ± 0.0 
C7: 3.0 ± 0.0 
C8: 3.0 ± 0.0 
C9: 3.0 ± 0.0 
C10:2.9 ± 0.1
C1: 3.0 
C3: 2.3 
C5: 3.0 
C8: 3.0 
C10: 2.8
C1: 2.8 
C5: 3.0 
C9: 3.0 
C10: 2.8
C1: 3.0 
C5: 3.0 
C7: 3.0 
C10: 3.0
C1: 3.0 
C2: 3.0 
C4: 2.8 
C5: 2.8 
C6: 3.0 
C10: 2.8
C1: 3.0 
C5: 3.0 
C8: 3.0 
C10: 3.0
C1: 2.8 
C4: 3.0 
C5: 3.0 
C10: 3.0
C1: 3.0 
C5: 2.3 
C6: 3.0 
C9: 3.0 
C10: 3.0
C2: 1.3 
C3: 2.3 
C7: 3.0

Therapist competence

(A) Style/ approach
mean ± SD 4.9 ± 0.1 5.0 ± 0.1 4.9 ± 0.1 5.0 ± 0.0 5.0 ± 0.0 5.0 ± 0.05.0 ± 0.0 5.0 ± 0.1 4.8 ± 0.1 
 C1–10: score for a given session in the assessed cohort C1: 5.0 ± 0.0 
C2: 4.8 ± 0.4 
C3: 4.8 ± 0.0 
C4: 5.0 ± 0.0 
C5: 5.0 ± 0.0 
C6: 5.0 ± 0.0 
C7: 4.8 ± 0.4 
C8: 4.9 ± 0.2 
C9: 5.0 ± 0.1 
C10 2.9 ± 0.1
C1: 5.0 
C3: 4.8 
C5: 5.0 
C8: 5.0 
C10: 5.0
C1: 5.0 
C5: 5.0 
C9: 5.0 
C10: 4.8
C1: 5.0 
C5: 5.0 
C7: 5.0 
C10: 5.0 
C1: 5.0 
C2: 5.0 
C4: 5.0 
C5: 5.0 
C6: 5.0 
C10: 5.0
C1: 5.0
C5: 5.0
C8: 5.0
C10: 5.0
C1: 5.0 
C4: 5.0 
C5: 5.0 
C10: 5.0
C1: 5.0 
C5: 5.0 
C6: 5.0 
C9: 4.8 
C10: 5.0
C2: 5.0 
C3: 4.8 
C7: 4.8

(B) Overall performance
mean ± SD 5.0 ± 0.1 4.9 ± 0.2 5.0 ± 0.0 5.0 ± 0.0 5.0 ± 0.0 5.0 ± 0.0 4.9 ± 0.1 5.0 ± 0.1 5.0 ± 0.0 
 C1–10: score for a given session in the assessed cohortC1: 5.0 ± 0.0 
C2: 5.0 ± 0.0 
C3: 4.8 ± 0.4 
C4: 4.9 ± 0.2 
C5: 5.0 ± 0.1 
C6: 5.0 ± 0.0 
C7: 5.0 ± 0.0 
C8: 5.0 ± 0.0 
C9: 5.0 ± 0.0
C1: 5.0 
C3: 4.5 
C5: 5.0 
C8: 5.0 
C10: 5.0
C1: 5.0 
C5: 5.0 
C9: 5.0 
C10: 5.0
C1: 5.0 
C5: 5.0 
C7: 5.0 
C10: 5.0 
C1: 5.0 
C2: 5.0 
C4: 5.0 
C5: 5.0 
C6: 5.0 
C10: 5.0
C1: 5.0 
C5: 5.0 
C8: 5.0 
C10: 5.0
C1: 5.0 
C4 4.8 
C5: 5.0 
C10: 5.0
C1: 5.0 
C5: 5.0 
C6: 5.0 
C9: 4.8 
C10: 5.0
C2: 5.0 
C3: 5.0 
C7: 5.0

C – Cohort; MBRP-AC - Mindfulness-Based Relapse Prevention Adherence and Competence scale; Score range for the presence of Key Treatment Components: 1 = the checklist item was addressed; 0 = the checklist item was not addressed; Score range for Discussion of Key Concepts for each of the four assessed domains (awareness of the current experience; acceptance of the current experience; acceptance versus aversion; acceptance and action): 3 = concept was discussed in detail and completely explained, 2 = discussed with some explanation but not as thoroughly or opportunities to discuss it further may have been missed, 1 = only briefly mentioned, 0 = not discussed; Score range for Therapist Style/Approach in general and for the mindfulness-related competence in four areas (inquiry or ability to elicit feedback and respond to verbal and nonverbal feedback; attitude or ability to model and embody the spirit of mindfulness; use of key questions or extent to which they were used to elicit discussion about practices/experiences; use of clarifying questions or extent to which the therapist addressed and clarified ideas or misconceptions about MM): 5 = the therapist consistently demonstrated desired style/approach; 4 = during most but not the whole session; 3 = for approximately half of the session; 2 = infrequently; 1 = absence of such style/approach; Score range for Overall Performance for each of the four assessed domains (the overall quality of the therapy; therapist/researcher ability to work as a team; therapist ability to keep the session focused on the topic; the overall quality of MM delivery): 5 = the overall performance was “excellent,” consistent with the manual; 4 = was “good,” with only minor deficiencies in a small portion of the session; 3 = was “satisfactory,” consistently less than excellent; 2 = was “mediocre,” consistently less than satisfactory; 1 = was “not satisfactory,” with poor performance throughout the session.