The majority of psychological research has focused on outcomes of intervention, while there has been relatively little focus on measuring adherence to treatment protocol and how competently interventions are delivered. Issues of adherence and competence apply not only to psychotherapy research, but also in the field of cognitive training. The New England Cognitive Center (NECC) has disseminated manualized cognitive training programs for older adults who may be experiencing varying levels of cognitive decline. The purpose of the current study was to develop measures of adherence and competence for the Active Mind cognitive training program created by the NECC as well as to refine the content of the instruments and examine their psychometric properties. The current study found that the Active Mind Adherence Instrument and Global Adherence/Competence Instrument have fair to substantial inter-observer reliability. These data suggest that program facilitators are completing the required tasks at a high level, and are therefore, appropriately adhering to the treatment manual. Reliability data for the measure of competence was somewhat lower, suggesting that assessing competence requires more subjective judgement and improvements to the exiting instrument are needed. Results suggest that the adherence measure can be used to provide detailed, constructive feedback to ensure the proper delivery of the Active Mind cognitive training program, while the competency measure requires modifications before it can be used to evaluate program facilitators.


Jeffrey Buchanan

Committee Member

Bradley Arsznov

Committee Member

Donald Ebel

Date of Degree




Document Type



Master of Arts (MA)




Social and Behavioral Sciences



Rights Statement

In Copyright