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How the rating is done

To be valid, we believe that a fidelity assessment must be done in person, i.e., through a site visit. The fidelity assessment requires a minimum of 5 hours to complete, although a longer period of assessment will offer more opportunity to collect information and hence should result in a more valid assessment. The data collection procedures include chart review, session observation, and semi-structured interviews with the program coordinator, clinicians and supervisors, and family members. If the FPE program has 3 or fewer clinicians, attempts should be made to interview all. If the program has more than 3 clinicians, a minimum of 3 should be sampled for an interview. It is recommended that interviews with clinicians be done in a group format.

For the items that require interviews with family members, we suggest that at least 3 family members (from unique families) be interviewed. The program coordinator should be contacted to help you identify and set up these interviews.

For some items that require chart review for rating, 10 charts shall be randomly selected. We suggest that you ask the program coordinator to select 20 charts beforehand and then randomly select and review 10 of those charts during your site visit. The charts should include one client whose family is seen for each FPE clinician to be interviewed. Some items are to be rated by observing a session. The rating may be done either by observing a live session or by viewing a previously videotaped session, which should be determined by negotiating with each program.

Who does the ratings

The scale can be administered internally by a program or by an external review group. If it is administered internally, it is obviously important for the ratings be made objectively, based on hard evidence, rather than making ratings to look good. Circumstances will dictate decisions in this area, but we encourage agencies to choose a review process that fosters objectivity in ratings, e.g., by involving a staff person who is not centrally involved in providing the service. With regard to external reviews, there is a distinct advantage in using assessors who are familiar with the program, but at the same time are independent. The goal in this process is the selection of objective and competent assessors.

Fidelity assessments should be administered by individuals who have experience and training in interviewing and data collection procedures (including chart reviews). In addition, interviewers need to have an understanding of the nature and critical ingredients of FPE. We recommend that all fidelity assessments be conducted by at least two assessors.

Missing data

The scale is designed to be completely filled out, with no missing data on any items. Therefore, it is essential that assessors obtain the required information for every item. If information cannot be obtained at time of the site visit, it will be important for you to be able to collect at a later date.

References

Dixon, L. & Lehman, A.F. (1995). Family interventions for schizophrenia. Schizophrenia Bulletin, 21, 631-643.

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