Fidelity scale: From black box to holy grail

J. van Weeghel*

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

1 Citation (Scopus)
14 Downloads (Pure)


Fidelity scales are indispensable in the pursuit of evidence-based mental healthcare. Without fdelity checks, treatment remains a mysterious black box. The aim of this article is to comment on the studies in this special section, and to discuss some general issues with regard to fdelity assessment. Despite all of their supposed benefts, resistance to fdelity scales persists among mental health practitioners. One way to overcome this resistance is to conduct fdelity assessments in the context of a well-guided learning community. The predictive validity of fdelity scales is considered the single most valuable attribute of these instruments. Research on predictive validity requires large sample sizes, which is difcult to achieve. It should nevertheless not prevent us from rigorously searching for this Holy Grail of fdelity assessment. In addition, fdelity
assessment should be placed in a broader perspective. The quality of care for people with severe mental illness cannot be assessed conclusively according to the extent to which separate interventions have been applied with good fdelity. These individuals need access to high-quality treatment and support systems within the community, which can enable them to live their lives as valued citizens. In conclusion, fdelity assessment, both at the level of interventions and systems, contributes to a highly desirable transparency in practice variations within the feld of mental healthcare.
Original languageEnglish
Number of pages5
JournalAdministration and Policy in Mental Health and Mental Health Services Research
Publication statusPublished - 2020


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