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This article describes the process of developing a manual of therapeutic interventions of ten different modalities. With this manual, independent raters can identify the therapeutic interventions occurring in a therapy session. In research, this is called the control of treatment adherence. The article also presents some results shown by using this manual. A surprising finding was that treatment fidelity was rather low in all treatment modalities. Therapists in all modalities were identified as using between 4.7% and 32.5% of interventions specific to their school of psychotherapy. Nonspecific interventions ranged between 51.4% and 73.2% of all interventions identified. Between 14.8% and 24.8% were identified as interventions from other treatment modalities. Keywords: psychotherapy research, naturalistic design, treatment adherence, Manual of therapeutic interventions, Gestalt therapy, specific and non-specific interventions

Erworben im Rahmen der Schweizer Nationallizenzen (http://www.nationallizenzen.ch), Previous results have demonstrated that psychotherapists working in a practice setting have a relatively low treatment adherence, regardless of the therapy school to which they were affiliated. The objective of this study was to investigate whether the therapist’s attitudes in therapeutic matters are a better predictor of interventions employed than the therapeutic method in which the therapist was trained. The relationships between various types of psychotherapeutic intervention and both predictors were tested by means of Markov Chain Monte Carlo simulations. A total of 162 therapy sessions conducted by 18 therapists affiliated to 6 different therapeutic methods were analyzed. The interventions were classified according to the criteria of essentiality and commonality. The analysis showed that 40% of the examined intervention types were significantly associated with at least one of the nine attitude scales considered, whereas only 14% exhibited a significant association with the completed type of therapy training. The latter predictor was only associated with interventions of the kind essential/not common, whereas the attitude scales were related with both essential and common interventions. The rather weak association between the type of completed training and preferred therapeutic intervention types means that many essential intervention techniques acquired during training assume a subordinate role in a practice setting. Choice of therapeutic action is conditioned to a greater extent by nuances in individual attitudes, which may change throughout a professional career. The reciprocal influence of a psychotherapist’s attitude and his or her professional development is discussed.