A Measure for Supporting Implementation of Telehealth Direct Therapy With Treatment Integrity
Grab the Telehealth Therapy Treatment Integrity Measure to standardize coaching and session review in your online cases.
01Research in Context
What this study did
Nohelty et al. (2021) built a checklist for telehealth direct therapy. The tool lists what the therapist and the client must do during each online session.
The authors did not test the tool with families. They only show how to score each item and give sample checklists.
What they found
The paper gives a ready-to-use form. It covers client safety, tech checks, teaching trials, and data recording.
No outcome data are reported. The tool is offered as a template for others to adopt.
How this fits with other research
Spackman et al. (2025) and Tsami et al. (2019) already show parents can run full FAs and FCT online with big behavior drops. Their studies used informal coaching scripts. The new measure could standardize those loose scripts into one integrity score.
Larsen et al. (2023) looked back at real telehealth FA/FCT tapes. They found therapists rely on friendly chat more than clear instructions. The new checklist would flag that imbalance and push coaches toward clearer prompts.
Wormald et al. (2019) tracked parent fidelity with their own form and hit 90 % behavior reduction. The new tool offers a public version so other teams do not have to build a fidelity sheet from scratch.
Why it matters
If you run telehealth sessions you now have a free integrity form. Use it to train new staff, give live feedback, and keep parents and therapists on the same page. No need to invent your own checklist.
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02At a glance
03Original 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.
Behavior Analysis in Practice, 2021 · doi:10.1007/s40617-020-00543-7