Treatment Integrity and Members’ Change in Group Counseling: A Pilot Study on Counselor's Mentalizing Intervention

Treatment integrity includes adherence to a therapeutic model and competence in delivering interventions. In group psychotherapy research, the association between a clinician’s treatment integrity and therapeutic effectiveness has received little attention. However, the issue has recently become a focus of interest for mentalization-based group therapy (MBT-G), and research instruments for studying clinician’s treatment integrity have been developed. This pilot study is aimed at analyzing the association between treatment integrity and change in underachieving university students from Italy who received nine sessions of group counseling aimed at promoting mentalization to enhance their academic performance. The effectiveness of the counseling groups was assessed with the Academic Performance Inventory. Transcripts of 18 sessions from two groups were analyzed using: (a) the Innovative Moments Coding System—a reliable method for studying change by tracking narrative innovations along the therapeutic process, and (b) the Mentalization-based Group Therapy Adherence and Quality Scale—assessing 19 types of mentalizing interventions. The results indicate that adherent interventions should be provided with high quality. Good treatment results require techniques consistent with the theoretical model, but also, most importantly, these techniques have to be delivered competently.