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      A Measure for Supporting Implementation of Telehealth Direct Therapy With Treatment Integrity

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          Abstract

          As telehealth direct therapy sessions are being increasingly provided for safety reasons during the COVID-19 pandemic, it is critical to ensure that sessions are implemented with integrity by direct service providers. Although existing research addresses the efficacy of the telehealth model, there is no literature on integrity measures tied to this service model. Without a framework or point of reference, clinicians new to the field of telehealth direct therapy may not be able or willing to attempt to implement it. The Telehealth Therapy Treatment Integrity Measure is designed to delineate components of effective telehealth direct therapy, including aspects of both instruction that should be generalized from in-person sessions to telehealth direct therapy sessions and new elements that are unique to telehealth direct therapy. A description of how the measure can be used to support the training, both initial and ongoing, of direct service providers is included. This measure can support clinicians in ensuring that direct service providers are working within their scope of competence when providing telehealth direct therapy.

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          Most cited references12

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          An implicit technology of generalization1

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            Telehealth and autism: A systematic search and review of the literature

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              Artifact, bias, and complexity of assessment: the ABCs of reliability.

              Interobserver agreement (also referred to here as "reliability") is influenced by diverse sources of artifact, bias, and complexity of the assessment procedures. The literature on reliability assessment frequently has focused on the different methods of computing reliability and the circumstances under which these methods are appropriate. Yet, the credence accorded estimates of interobserver agreement, computed by any method, presupposes eliminating sources of bias that can spuriously affect agreement. The present paper reviews evidence pertaining to various sources of artifact and bias, as well as characteristics of assessment that influence interpretation of interobserver agreement. These include reactivity of reliability assessment, observer drift, complexity of response codes and behavioral observations, observer expectancies and feedback, and others. Recommendations are provided for eliminating or minimizing the influence of these factors from interobserver agreement.
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                Author and article information

                Contributors
                K.Nohelty@centerforautism.com
                Journal
                Behav Anal Pract
                Behav Anal Pract
                Behavior Analysis in Practice
                Springer International Publishing (Cham )
                1998-1929
                2196-8934
                6 April 2021
                : 1-12
                Affiliations
                GRID grid.459423.d, Center for Autism and Related Disorders, ; 21600 Oxnard St., Suite 1800, Woodland Hills, CA 91367 USA
                Author information
                http://orcid.org/0000-0001-5067-7536
                Article
                543
                10.1007/s40617-020-00543-7
                8023556
                7ee1a130-ced5-4e18-8330-58c07c15fadb
                © Association for Behavior Analysis International 2021

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                : 11 December 2020
                Categories
                Technical and Tutorials

                treatment integrity,telehealth,covid-19,training
                treatment integrity, telehealth, covid-19, training

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