Is treatment integrity best assessed through self-report?

Treatment integrity refers to the fidelity with which an intervention is implemented according to its prescribed components. Assessing treatment integrity through self-report may not provide an accurate or objective measure of how well the treatment is being followed. Self-reporting can be influenced by personal bias, motivation, or misunderstanding of the treatment protocol, which can lead to optimism bias or underreporting of issues.

To effectively assess treatment integrity, it is generally more reliable to use direct observation or data collection methods that provide objective evidence of implementation. This approach allows for a clearer understanding of whether the intervention is being delivered as intended, which is crucial for evaluating its effectiveness. Therefore, relying on self-report alone is insufficient for ensuring treatment integrity in behavioral interventions.