{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T23:58:13Z","timestamp":1769385493331,"version":"3.49.0"},"reference-count":43,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2022,8,12]],"date-time":"2022-08-12T00:00:00Z","timestamp":1660262400000},"content-version":"unspecified","delay-in-days":223,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"United Kingdom Department for International Development","award":["201446"],"award-info":[{"award-number":["201446"]}]},{"name":"British Medical Research Council, Wellcome Trust and DFID","award":["MR\/M014290\/1"],"award-info":[{"award-number":["MR\/M014290\/1"]}]}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Glob. Ment. Health"],"published-print":{"date-parts":[[2022]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S2054425122000401_sec_a1\"><jats:title>Background<\/jats:title><jats:p>The<jats:underline>EN<\/jats:underline>hancing<jats:underline>A<\/jats:underline>ssessment of<jats:underline>C<\/jats:underline>ommon<jats:underline>T<\/jats:underline>herapeutic factors (ENACT) tool measures a set of therapeutic competencies required for the effective psychological intervention, including delivery by non-specialists. This paper describes the systematic adaptation of the ENACT for the South African (SA) context and presents the tool's initial psychometric properties.<\/jats:p><\/jats:sec><jats:sec id=\"S2054425122000401_sec_a2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>We employed a four-step process: (1) Item generation: 204 therapeutic factors were generated by SA psychologists and drawn from the original ENACT as potential items; (2) Item relevance: SA therapists identified 96 items that were thematically coded according to their relationship to one another and were assigned to six domains; (3) Item utility: The ENACT-SA scale was piloted by rating recordings of psychological therapy sessions and stakeholder input; and (4) Psychometric properties: Internal consistency and inter-rater reliability of the final 12-item ENACT-SA were explored using Cronbach's alpha and intraclass correlation co-efficient (ICC) for both clinical psychologists and registered counsellors.<\/jats:p><\/jats:sec><jats:sec id=\"S2054425122000401_sec_a3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Although the original ENACT provided a framework for developing a tool for use in SA, several modifications were made to improve the applicability of the tool for the SA context, and optimise its adaptability other contexts. The adapted 12-item tool's internal consistency was good, while the inter-rater reliability was acceptable for both clinical psychologists and registered counsellors.<\/jats:p><\/jats:sec><jats:sec id=\"S2054425122000401_sec_a4\" sec-type=\"conclusions\"><jats:title>Conclusion<\/jats:title><jats:p>The ENACT-SA is a reliable tool to assess common factors in psychological treatments. It is recommended that the tool be used in conjunction with assessment protocols and treatment-specific competency measures to fully assess implementation fidelity and potential mechanisms of therapeutic change.<\/jats:p><\/jats:sec>","DOI":"10.1017\/gmh.2022.40","type":"journal-article","created":{"date-parts":[[2022,8,12]],"date-time":"2022-08-12T09:01:44Z","timestamp":1660294904000},"page":"375-383","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":8,"title":["ENhancing Assessment of Common Therapeutic factors (ENACT) tool: adaptation and psychometric properties in South 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