Treatment integrity checklist items
| Item | Response options | Cognitive therapy | Exposure therapy |
|---|---|---|---|
| 1 | Yes/no/or N/A (not applicable) | Eliciting automatic thoughts: gambling related | Cash management: effective plan established and agreed by the client |
| 2 | Yes/no/or N/A | Case conceptualisation: linking beliefs and thoughts with behaviour, eliciting feedback from client regarding validity and usefulness | Case conceptualisation: linking autonomic responses with behaviour, eliciting feedback from client regarding validity and usefulness |
| 3 | Yes/no/or N/A | Sharing conceptualisation with client: used meaningful examples | Sharing conceptualisation with client: used meaningful examples |
| 4 | Yes/no/or N/A | Eliciting core beliefs/schemata: gambling related | Eliciting autonomic symptoms, thoughts, and behaviours: gambling related |
| 5 | Yes/no/or N/A | Addressing key issues: raised key issues and related them to cognition and behaviour | Setting and conduct of exposure tasks: appropriately graded, focused, prolonged and repeated; agreed by the client; relevant to therapy goals |
| 6 | Yes/no/or N/A | Guided discovery: Socratic questioning, reflective/confronting (eg, what would that mean?)/interpretive responses to guide client's understanding | Addressing key issues: raised key issues and related them to urge and behaviour |
| 7 | Yes/no/or N/A | Asking for alternative thoughts: alternative views/explanations appropriately followed through | Habituation: evidence that the therapist assisted the client to identify and habituate to spontaneous urges |
| 8 | Yes/no/or N/A | Use of alternative cognitive techniques: appropriately selected and applied, relevant to therapy goals | Use of alternative behavioural techniques: appropriately selected and applied, relevant to therapy goals |
| 9 | 0–10-Likert scale | Overall rating of integrity | Overall rating of integrity |
| 10 | Unlimited free form text | Overall use of appropriate technique (specifically, please comment on any area of the session which may not have adhered to the allocated therapeutic approach) | Overall use of appropriate technique (specifically, please comment on any area of the session which may not have adhered to the allocated therapeutic approach) |