Abstract: Fidelity in psychotherapy refers to the extent to which treatment is delivered as intended. It is an important indicator of clinical quality and of the reliability of therapeutic outcomes. To address the limited domestic research on fidelity in psychotherapy process evaluation, this article reviews its conceptual structure and the need for its assessment, compares common assessment methods, and discusses current strategies for improvement. Existing studies suggest that observational coding, written surveys, and behavioral rehearsals each have distinct features and limitations. Across current approaches, major challenges include high time and labor costs, limited applicability, and low scoring consistency. Recent efforts to develop assessment frameworks, specify intervention procedures, and introduce computer-assisted assessment have improved standardization and efficiency to some extent. However, the long-standing problems of high cost and inconsistent assessment remain unresolved. Future research may further refine the assessment framework, develop a more systematic knowledge base, and continue to explore and validate automated tools such as large language models in psychotherapy settings, thereby advancing the quality assessment of psychotherapy processes from theoretical advocacy to standardized practice.

Key words: Fidelity, Psychotherapy, Psychological Counseling, Measurement Methods, Evaluation Framework