If DOT is not more effective for managing tuberculosis than is self-supervision of therapy, then acquisition and transmission of drug resistant strains should be similar in both counties.
For example, programs often focus exclusively on mothers to be responsible for children's health, oral rehydration therapy, or supervision of drug therapy for tuberculosis.
If possible, a directly observed treatment (DOT) strategy, which ensures supervision of oral therapy administration and the injection of subcutaneous therapy by health care professionals, should be used, as occurs in anti-HIV and tuberculosis treatment in prison inmates [ 19].
Our system would be of great interest in the supervision of physical therapy exercises in clinical as well as in non-clinical environments (e.g. rehabilitation at home).
Clinical supervision of individual therapy was provided during team consultation meetings (weekly by senior staff and monthly by TL).
Five mechanisms were used to maximise fidelity in the studies reviewed: use of a manualised intervention; attention to NSHW recruitment; NSHW training; regular supervision; and assessment of therapy quality.
Quarterly supervision of these antiretroviral therapy (ART) sites ensures high quality care, but the time currently dedicated to exhaustive record review and data cleaning detracts from other critical components.
With the exception of one psychologist who left the unit soon after the program was started, all therapists participate in a three-year core training in ISTDP (Intensive Short-Term Dynamic Psychotherapy) including supervision of video-taped therapy sessions.
The method of enquiry must, therefore, be a dynamic process of exploring the multiple layers of supervision, therapy, and client, and one that allows for the elaboration of both inner reflective activity and clarification of understanding developed through dialogue.
Peer-led supervision and the assessment of therapy quality may be one solution to address this barrier.
