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In this paper, we briefly review the current literature on treatment integrity and discuss the relevance of this procedure for detecting, measuring and ensuring that the proposed mechanisms of change in cognitive behavior therapy, in this case of acceptance and commitment therapy (ACT; S.C. Hayes, Strosahl, & Wilson, 1999), take place. We discuss aspects such as how to develop an integrity coding system that takes into account the nuances of the ACT model, critical factors when deciding the different processes to include in the coding manual, and suggestions for how to operationalize the distinction between adherence and competence from an ACT perspective. In addition, we also provide more specific guidance about issues as how to select the segments to be coded, the training of those who will code the intervention, and the interrater reliability process. Finally, we provide the reader with a complete example of a treatment integrity coding manual that was specifically adapted for a randomized controlled trial in the treatment of obsessive compulsive disorder (Twohig et al., 2010a). The aim of the current paper is to provide some essential tools for ACT researchers to develop treatment integrity protocols so that they are more encouraged to adopt such methods in their studies.
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