Adherence consists of demonstrated mastery in BSFT problem and intervention formulation skills, and BSFT treatment skills in each of the four BSFT domains. Focusing adherence on the BSFT treatment domains will identify fidelity issues earlier, provide clear direction for individual clinicians, and guide both the clinician and supervisor toward effective remediation. The BSFT model co-developer periodically reviews each agency and clinician for fidelity, and will recommend any adaptations or other measures that will improve utilization and outcomes.

Research has proven that lack of adherence and fidelity to an EBP produces negative results that mislabel the EBP as inadequate and ineffective.

FTTIM helps clinicians and their agencies, in tandem, create an environment that maintains programmatic fidelity in all aspects. In helping organizations successfully implement BSFT we have to see that the system be congruent theoretically and clinically with the model. If not, symptoms appear (poor outcomes, engagement and retention failures, loss of fidelity, staff turnover). The EBP then becomes, as we say in Family Therapy lingo, the Identified Patient of the agency system. As effectiveness decreases, funding is lost….the EBP dies.