Training and fidelity monitoring of behavioral interventions in multi-site addictions research.

In this article, methods for the training and fidelity monitoring of behavioral interventions in multi-site addictions research are reviewed, including five published studies and seven ongoing studies sponsored by the National Institute on Drug Abuse-funded Clinical Trials Network (CTN-0004/5, CTN-0009, CTN-0014, CTN-0015, CTN-0017, CTN-0018/19, and CTN-0020). Methods are categorized and reviewed consistent with a technology model of treatment delivery. Topics include: therapist selection, training, certification, and supervision; selection, training, and certification of supervisors; scales and processes used for monitoring of the quality of treatment; and processes followed to provide new training for replacement staff once trials have begun.

This review reveals both a wide array of procedures and emerging standards for multi-site trials. Methods used in multi-site trials are important not only to ensure validity of those trials, but also inform the wider dissemination of empirically based treatment into community agencies. Training and fidelity models that delegate responsibility to participating sites appear most relevant for establishing best practices for dissemination of behavioral interventions. The effectiveness of these distributed training and supervision models should be subjected to empirical study at a level of rigor comparable to the evaluation of their corresponding treatments.