Fidelity Assessment of Peer-Delivered Cognitive-Behavioral Therapy for Postpartum Depression

Objective: Fidelity assessment of peer-administered interventions (PAIs) by expert therapists can be costly and limit scalability. This study ' s objective was to determine whether peer facilitators could assess the fidelity of peer-delivered group cognitive-behavioral therapy (CBT) for postpartum depression as effectively as an expert psychiatrist or a trained graduate student. Methods: Intervention adherence and competence were assessed by three peers (N=9 sessions) and by one expert psychiatrist and one graduate student (N=18 sessions). Interrater reliability was assessed with intraclass correlation coefficients (ICCs). Results: ICCs were good to excellent (0.88-0.98) for adherence and competence ratings among the three types of raters (psychiatrist vs. peers, psychiatrist vs. student, and student vs. peers). Conclusions: Trained peers may be able to reliably rate the fidelity of a PAI for postpartum depression. This preliminary study represents the first step toward peer-led feedback as an alternative to expert-led supervision of peer-delivered group CBT for postpartum depression.