Table 2 Summary of the clinical advisory team’s comments and recommendations regarding the acceptability and delivery of the specific intervention techniques

Goal specified AND

Having specific goals for therapists (as opposed to therapy goals for patients) is likely to range from contentious to highly unacceptable.

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Having goals for a team is likely to require persuasion, and success is likely to depend on the goals. Supportive and encouraging, rather than normative, team goals are likely to be more acceptable.

Goals that allow measurement of progress or comparison between individual therapists are likely to be highly unacceptable.

“Targets” are likely to be associated with “sales” and thus likely to be strongly opposed to therapists’ professional identity.

Self-monitoring AND feedback

In general, any monitoring or feedback, and especially external monitoring/feedback, about individual therapists’ practice is likely to be highly unacceptable.

Low levels of self-monitoring might be acceptable if combined with use of social processes of encouragement and support.

Rewards

Social support and encouragement is valued very highly.

Graded tasks AND

Highly desirable, especially for the target behaviours of formulating goals and agreeing goals—for as long as the tasks were presented in a way that was relevant to practice.

Rehearsal of relevant skills

Could involve grading the target behaviours in terms of the other people involved (e.g., whether goals are formulated with parent or with the child) and context.

Coping skills

Current method of coping with emotional aspects of practice is to draw on professional community for support; this is effective and preferable to therapists.

Social processes of encouragement and support

Emphasis should be on mutual support, positive interactions, and sharing.

Changing practice as part of a team is likely to be more acceptable than changing practice individually.

This technique should be included in all aspects of the intervention as far as possible and in high dose and frequency.

Social processes of pressure

It might be acceptable to establish some team norms, but these would need to be carefully negotiated if therapists’ motivation to comply with the norms is hoped to be gained.

Explicit social pressure from colleagues or manager is likely to be highly unacceptable, and the intervention should be designed so that it cannot be used to exert pressure.

It might be acceptable to include expectations from parents, but acceptability of this is likely to be contingent on therapists’ holding a professional norm about the importance of client-centred practice.

Any technique that is not, or appears not to be, in line with being an autonomous practitioner is likely to be rejected.

Modeling/ demonstration of the behaviour

Examples by others, as part of the social processes of support, would be desirable.