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Adherence Rater

We are seeking Adherence Raters who are fluent in English and either Spanish, Dutch, German, or Czech. This is a remote contract position. Pay is $30 per hour.

Job Description:

"Treatment fidelity is the ongoing assessment, monitoring, and enhancement of the reliability and internal validity of a study (1). Treatment fidelity helps to increase scientific confidence that the changes in the dependent variable (outcome of interest) are due to manipulations of the independent variable..."
— Borrelli, B. (2011). The Assessment, Monitoring, and Enhancement of Treatment Fidelity In Public Health Clinical Trials. Journal of Public Health Dentistry, 71(s1), S52-S63.

Adherence Raters support MAPS-sponsored MDMA-assisted psychotherapy trials, by assessing treatment integrity. Trained Adherence Raters view recorded therapy sessions and rate provider competence and adherence to the treatment method based on defined criteria.

Adherence Rater Qualifications :

Due to the specialized and sensitive nature of the work that is involved, it is important for an Adherence Rater to have the proper qualifications. The ideal background for an Adherence Rater would be someone eager to learn about MDMA-assisted psychotherapy, who is either a licensed therapist or in training to be a licensed therapist. The following qualifications are deemed essential:

  • Motivation for self-development in the therapeutic field
  • Eagerness to learn about MDMA-assisted psychotherapy
  • Formal, graduate-level training in psychotherapy
  • Licensed as a therapist or training to be a licensed therapist
  • Psychotherapy internship or equivalent experience with direct patient contact
  • One year of experience working with trauma population or equivalent
  • Training in the sensitive and confidential nature of the subject material
  • High-level of openness to feedback
  • Discrete access to the Internet in a private setting on a personal computer
  • Completion of MAPS Adherence Rater training

Applicants are referred to Adherence Trainers who screen CVs and assess qualifications for essential requirements. Only those applicants meeting the requirements will be accepted for training. Applicants accepted for training will receive access to training materials, any additional instructions, and an invitation to an upcoming instructional session.

Adherence Rater Training:

Before reviewing video sessions, prospective Adherence Rater Trainees must submit a CV, a signed Confidentiality Agreement, and documentation of HIPAA certification to the Sponsor. Once each training module is completed and relevant documents are filed, Adherence Rater Trainees can begin rating session video. Before becoming a fully certified Adherence Rater, new Adherence Rater Trainees will need to address each of the following training modules:

  • Read the Therapist Treatment Manual: “A Manual for MDMA-Assisted Psychotherapy in the Treatment of Posttraumatic Stress Disorder”
  • Read the Adherence Manual “MDMA-Assisted Psychotherapy Adherence and Competence Ratings Manual”
  • Watch the Mithoefers’ Workshop “Principles of Psychedelic Psychotherapy-Lessons from MDMA Research for PTSD”
  • Complete the HIPAA Tutorial (
  • Attend an in-person instructor-led training session and rate the presented video
  • Complete the Inter-rater Reliability Process, which involves calibration Adherence and Competence ratings and trainer feedback
  • Complete the Adherence and Competence Rater Training Checklist

Primary Adherence Rater Duties:

Adherence Raters complete all Adherence Rater trainings, establish Inter-rater Reliability, and report to Adherence Rater Managers as assigned. Adherence Raters are tasked with the following roles and responsibilities:

  • Watching and coding video
  • Completing Source Records containing ratings and relevant feedback by due date
  • Being available for a comment period lasting two weeks after Rating submission
  • Attending ongoing administrative supervision meetings and check-ins
  • Working with other Adherence Raters as part of self-care team
  • Ongoing cohesive communication with other Adherence Raters and Managers
  • Ensuring technical set-up is maintained to privately view videos

Inter-rater Reliability Process:

The Inter-rater Reliability process is designed to standardize the assignment of ratings to ensure that Adherence Raters are applying the method consistently. Calibration video sessions will be selected by the Sponsor Supervisor and scored by all available Adherence Raters. These ratings will be converted into quantitative data and correlated to the ratings scores of a Senior Adherence Rater Manager, whose ratings serve as a “gold standard”. The Sponsor Supervisor will examine the variability in the data to identify items that need to be discussed with Trainees. This process can be repeated, on an individual basis or by the group, as many times as necessary, until each Trainee is reliable.

Adherence Rater Trainees must rate at least three video sessions (one preparatory, one experimental, and one integrative session) that have been rated by the gold standard. The Cohen’s Kappa (κ) must be greater than or equal to 0.50 to establish Inter-rater Reliability. Adherence Rater Trainees who provide ratings that do not meet the criteria (κ ≥ 0.50) shall complete a second set of three ratings, to be included in a subsequent correlation analysis for comparison to the gold standard ratings. Any Trainee who is unable to establish Inter-rater Reliability after two rounds of Kappa analysis must complete additional training in order to continue in the training program.

To apply, email This email address is being protected from spambots. You need JavaScript enabled to view it. .

About Us:

Investigators are conducting a randomized, double-blind, placebo-controlled, multi-site phase 3 study of the efficacy and safety of manualized MDMA-assisted psychotherapy for the treatment of severe posttraumatic stress disorder. MDMA is a Schedule 1 controlled substance. This study is sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS), a non-profit, membership-based research and educational organization and is being conducted as a pharmaceutical trial under the jurisdiction of the US FDA. MAPS' mission is 1) to treat conditions for which traditional medicines provide limited relief—such as posttraumatic stress disorder (PTSD), pain, drug dependence, and anxiety and depression associated with end-of-life issues—by developing psychedelics and marijuana into prescription medicines; 2) to cure people by building a network of clinics where treatments can be provided; and 3) to educate the public honestly about the risks and benefits of these drugs.