For the best chance of a positive impact on educational outcomes, two conditions must be met: (a) Effective interventions must be adopted, and (b) those interventions must be implemented with sufficient quality (treatment integrity) to ensure benefit. To date, emphasis in education has been on identifying effective interventions and less concern with implementing the interventions. The research on the implementation of interventions is not encouraging. Often, treatment integrity scores are very low and, in practice, implementation is rarely assessed. If an intervention with a strong research base is not implemented with a high level of treatment integrity, then the students do not actually experience the intervention and there is no reason to assume they will benefit from it. Under these circumstances, it is not possible to know if poor outcomes are the result of an ineffective intervention or poor implementation of that intervention. Historically, treatment integrity has been defined as implementing an intervention as prescribed. More recently, it has been conceptualized as having multiple dimensions, among them dosage and adherence which must be measured to ensure that it is occurring at adequate levels.
Citation: Detrich, R., States, J., & Keyworth, R. (2107). Overview of Treatment Integrity. Oakland, Ca. The Wing Institute.