Manualization of Occupational Therapy Interventions: A Crucial but Overlooked Step in Building Evidence

Manualization of an intervention is an essential component in the implementation of research studies. When collaborating on research teams, manualization gives a template to check for fidelity and thus determine if the intervention is carried out in the way in which it was intended by the program developers. Murphy and Gutman (2012) have outlined essential elements in intervention fidelity that are often absent from study descriptions. For example, within the intervention manual researchers should describe the intervention design to include the number, length, and frequency of intervention sessions. The researchers should explain both the theoretical framework and any clinical guidelines that provided the foundation for the intervention. The manual must also define the “active ingredients” or elements of the intervention proven to be responsible for changes in specific outcomes, often quite complex in intervention research. Careful consideration must be given to the training of individuals who will be implementing the study’s procedures. Implementation training is not only outlined in the manual, but the manual content can also be used for training purposes. Written/electronic intervention manuals can be an important tool to assist in fidelity as they provide a means to articulate the distinct differences of the intervention and ensure outcomes are replicated.