Development of the Brief Addiction Therapist Scale (BATS): A Tool for Evaluating Therapist Delivery of Psychological Therapies for Alcohol and Drug Use Problems

This thesis describes the development of the BATS: a brief, evidence-based tool monitoring and evaluating therapists’ delivery of psychological therapies used in routine practice for alcohol and drug use problems. The BATS is transtheoretical, applicable to the range of widely used therapies in addiction. Four studies were undertaken to develop the BATS. Study 1 identified twenty-six fidelity measures from the literature that evaluate therapists’ delivery of psychological therapies for alcohol and drug use problems. Study 2 generated items and response formats for potential inclusion in the BATS using the identified measures as a basis. Generation of the items was primarily based on the results of a thematic analysis; eighteen exemplar items were developed. Study 3 generated a consensus among experts in the fields of addiction and psychotherapy on the content of the BATS. A consensus was obtained using a three-round Delphi survey. At the conclusion of the third round, group agreement on the 12 scale items and response format was reached. This content formed the first version of the BATS. Study 4 tested the psychometric properties of the newly developed scale. The results provided support for inter-rater reliability and convergent validity. The BATS provides a reliable and valid method for evaluating treatment delivery in routine practice, helping to improve our understanding of the process of therapy in addiction. The real world application of the BATS provides a useful tool for training and supervision, which has the potential to impact on therapist competence and treatment delivery.