心理治疗的忠实度测量:现状与改进OACHSSCD

Fidelity in psychotherapy refers to the extent to which treatment is delivered as intended,serving as a key indicator of clinical quality and the reliability of therapeutic outcomes.Given the limited domestic research on fidelity in the evaluation of psychotherapy processes,this article reviews its conceptual structure and the rationale for its assessment,compares common assessment methods,and discusses current strategies for improvement.Existing studies indicate that observational coding,written surveys,and behavioral rehearsals each have distinct features and limitations.Across current approaches,major challenges include substantial demands on time and labor,limited applicability,and low scoring consistency.Recent efforts to develop assessment frameworks,specify intervention procedures,and introduce computer-assisted assessment have improved standardization and efficiency to some extent.However,the persistent issues of high costs and inconsistent assessment remain unresolved.Future research may further refine the assessment framework,establish a more systematic knowledge base,and continue exploring and validating automated tools such as large language models in psychotherapy settings,thereby advancing the quality assessment of psychotherapy processes from theoretical advocacy to standardized practice.