Date of Award

Fall 12-20-2012

Degree Type


Degree Name

Doctor of Philosophy (PhD)


Counseling and Psychological Services

First Advisor

Dr. Joel Meyers

Second Advisor

Dr. Kris Varjas

Third Advisor

Dr. Catherine Cadenhead

Fourth Advisor

Dr. Olga Jarrett


Treatment acceptability and treatment integrity are essential constructs to consider when designing, implementing, and evaluating school-based interventions. Existing literature has described treatment acceptability and treatment integrity as separate constructs rather than investigating their interrelationships. Also, models of treatment acceptability and treatment integrity have not systematically included the perspectives of multiple stakeholders, have not addressed multiple time points in the intervention process, and have not emphasized multiple methods of data collection. This paper reviewed extant literature related to current definitions and models of treatment acceptability and treatment integrity and presented a comprehensive integrated model of these constructs that addressed the aforementioned gaps in the intervention literature.

A mixed methods study exploring student, facilitator, and observer perceptions of treatment acceptability and treatment integrity of an eight-week bullying prevention intervention was conducted. The study investigated the role of cultural modifications (i.e., context-based procedural or curriculum changes employed to enhance the treatment acceptability or integrity of the intervention). Qualitative data were analyzed with an inductive-deductive approach (Nastasi et al., 2004). Deductive coding was used to illustrate components of treatment acceptability, treatment integrity, and cultural modifications salient to this research and an inductive approach was used to identify emerging themes. Consensus coding was conducted with greater than 90% interrater agreement. Quantitative data were analyzed using descriptive statistics. Qualitative and quantitative analyses revealed positive findings with respect to treatment acceptability and treatment integrity. Facilitator competence, behavior management, student engagement, and time management emerged as qualitative themes related to treatment integrity. Qualitative data suggested a positive relationship between student and facilitator perceptions of treatment acceptability. Qualitative findings revealed modifications to the curriculum content and delivery based on cultural factors (e.g., gender and age) to enhance treatment acceptability. Implications for school-based bullying research and applied practice were described. The results suggested that the use of mixed methods enhanced the comprehensiveness, depth, and quality of data regarding stakeholder perceptions of treatment integrity and treatment acceptability.