Title: A pilot fidelity study of Listen-Empathize-Agree-Partner (LEAP) with Assertive Community Treatment (ACT) mental health clinicians
Description: The primary objective of this study was to examine clinicians' fidelity to a promising new clinical intervention known as Listen-Empathize-Agree-Partner (LEAP) that addresses issues of poor insight, therapeutic alliance, and treatment adherence prevalent in the schizophrenia population. A secondary purpose of this study was to assess the factor structure of a measure developed to examine the core principles of the LEAP method. Forty-eight mental health clinicians working in Assertive Community Treatment (ACT) programs randomized into intervention and control groups were assessed for fidelity to the LEAP method via the LEAP Fidelity Measure (LFM), a self-report instrument. Results revealed a three-factor structure of this measure which were labeled "Reflective Listening, Delaying and Opining," "Partnering on Shared Goals," and "Client-Centered Listening and Empathizing." Multivariate Analyses of Variance indicated that clinicians who were trained in LEAP had significantly higher levels of fidelity to the "Reflective Listening, Delaying and Opining" and "Partnering on Shared Goals" components than clinicians who were not trained in this method.

There were no significant differences between the groups on the "Client-Centered Listening and Empathizing" component. Analyses did not reveal significant gender differences or effects based on years of general and specific ACT clinical experience between the two groups. However, in a post hoc analysis, a modest correlation between gender and fidelity to the "Client-Centered Listening and Empathizing" component showed that male clinicians tended to report higher fidelity to this specific set of interventions when compared to their female counterparts. These results are discussed within the context of feasibility in training and implementing LEAP in real-world community mental health clinical settings. Additionally, limitations of this study and implications for future research are discussed.