Therapietreue

Therapietreue is a term used in psychotherapy and health services research to describe how closely a therapeutic process follows the intended plan or protocol. The concept is often used in two related senses: patient adherence to a prescribed therapy (Therapieadhärenz) and therapist fidelity to a manualized intervention (Therapiefidelität or fidelity to the treatment protocol). In many German-language studies, Therapietreue encompasses both dimensions as a measure of treatment implementation quality.

Measurement and indicators vary by perspective. For patients, Therapietreue includes attendance at sessions, completion of prescribed exercises or homework, timely engagement with the treatment plan, and self-reported involvement. For therapists, fidelity is assessed with checklists, coding of sessions against manual criteria, and independent ratings. Combined measures aim to quantify the alignment between the planned therapy and what actually occurs in practice.

Factors influencing Therapietreue include patient motivation, perceived relevance and benefit of the treatment, the strength of the therapeutic alliance, symptom severity and duration, the complexity of the intervention, therapist training and supervision, and organizational factors such as scheduling and access to care.

Implications for practice and research are significant. Higher Therapietreue is generally associated with better treatment outcomes and more reliable evaluation of an intervention’s efficacy. Poor adherence or low fidelity can bias results and reduce effect sizes. Therefore, clinicians and researchers monitor and support Therapietreue through training, supervision, and structured protocols to promote consistent implementation.

See also: Therapieadhärenz, Therapiefidelität, Manualisierte Therapie, Therapeutische Allianz.