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Flexibility within Fidelity

Phillip Kendall

10 Jan 2024


Within the field of mental health services, and cognitive-behavioural therapy (CBT) specifically, there are programs that target specific disorders or disorders that cluster together.  Typically, each program comes with a therapist manual, a guidebook, or another form of instruction for proper implementation.  Ideally, these written materials are supplemented with face-to-face and experiential training.  Both proper implementation and successful outcomes follow after valuable learning experiences.

The event will be equivalent to 2 hrs of CPD.


The event will cover some of the biases that humans (including therapists) bring to decision making. How these decision-making biases impact mental health services will be considered. For example, the availability heuristic. Further consideration will be given to the “uniqueness” of cases, the expectations for outcomes, and the tendency to try to find shortcomings in and reasons to dismiss structured treatment programs.

Implementation of a treatment program includes making adjustments, and quality implementation of a treatment program desires informed flexibility. We will consider when adjustments are within fidelity and when they are not within fidelity. In addition, topics generated by participants will be discussed in terms of how they can be addressed with flexibility and within fidelity.

Learning Objectives

1 Recognize the information processing errors that humans make and how they can impact the provision of mental health services.
2 Identify the key components of treatment programs that are necessary for fidelity.
3 Identify how to be flexible when making adjustments to treatment programs and still maintain fidelity.

Training Modalities

Didactic content, Q and A, and group discussion. A PowerPoint will steer the event content.

Key References

Kendall, P. C. (2022) (Ed). Flexibility within Fidelity: Breathing Life into a Psychological Treatment Manual.  NY: Oxford University Press

Kendall, P. C., Ney, J., Maxwell, C., Lehrbach, K., Jakubovic, R., Mcknight, D., & Friedman, A. (2023). Adapting CBT for youth anxiety: Flexibility, within fidelity, in different settings. Frontiers in Psychiatry, 14, 194-.

Kendall P. C., Maxwell, C., Jakubovic, R., Ney, J., McKnight, D., Baker, S. (in press). CBT for youth anxiety: How does it fit within community mental health? Current Psychiatry Reports, in press.

Kendall, P. C. & Frank, H. (2018). Implementing evidence-based treatment protocols: Flexibility within fidelity. Clinical Psychology: Science and Practice, 25, 1-12. DOI: 10.1111/cpsp.12271.

Beidas, R., Benjamin, C., Puleo, C., Edmunds, J., & Kendall, P. C. (2010).  Flexible
applications of The Coping Cat Program for anxious youth. Cognitive and Behavioral Practice, 17, 142-153. [contains video]

About the presenter

Philip C. Kendall PhD, ABPP has over 800 publications and his treatments have been translated into over a dozen languages. He was identified as a most "Highly-Cited" individual in all of the social and medical sciences and was ranked 5th in an analysis of the faculty in the 157 American Psychological Association approved programs in clinical psychology in the US. His Google Scholar H index ias149.

Dr. Kendall has been a Fellow at the Center for Advanced Study in the Behavioral Sciences, received a "Great Teacher" award and was named a Distinguished University Professor at Temple University, and was identified as a "top therapist" by Philadelphia Magazine. In 2022, he was awarded the "Gold Medal Award for Impact in Psychology" by the American Psychological Foundation of AP A. His seminal works include the treatment of anxiety disorders in youth, cognitive-behavioral theory, research methodology, and the conceptualizing and understanding of psychopathology and treatment of children and adolescents. Phil is known for his clinical sensitivity, rigorous research methods, creative and integrative approaches, and commitment to graduate and professional training.

Who should attend

Anyone who works in the various mental health fields is welcome to attend and participate. Because I work mostly with adolescents and children with anxiety, some examples will include these samples and this disorder, but the general content and thrust of the presentation includes adults and is applicable to anyone providing mental health services across the lifespan.

Low Intensity clinical contact hours survey - BABCP Low Intensity Special Interest Group

Please click below if you are interested in contributing to the survey.


The BACP Low Intensity SIG are interested in the impact of clinical contact hours on Low Intensity/Wellbeing Practitioner wellbeing. This questionnaire contains six multi-choice questions and a free text box for you to share your experiences. The answers to these questions will help the BABCP SIG plan how to meet CPD topics and other developments within the SIG.  The SIG hope to produce a write up of the answers to this questionnaire to be shared with SIG members and to be used in training.

View Survey

This FREE conference is for Psychological Wellbeing Practitioners working in Talking Therapies for Anxiety and Depression services and is brought to you by Bespoke Mental Health in collaboration with the NHS England Talking Therapies National PWP Leads Network

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