The results of applying the MFRM support the presence of two distinct dimensions of adherence to CM for the treatment of adolescent substance abuse: cognitive-behavioral (CB) and monitoring techniques (MON). The original rating scale was found to perform differently for CB and MON items, in that respondents distinguished a middle level of CB adherence, but considered MON adherence as either having occurred or not occurred. In addition, the middle category ("Some") for CB items covered a wide range of the rating scale construct, suggesting that future applications of the CM-therapist adherence measure (CM-TAM) might include an additional level. One CB item and two MON items were found to perform poorly. Future applications of the CM-TAM should remove or modify these items. Although findings support the performance of the remaining CB and MONO items, the limited range of therapist adherence targeted by the items is important. Thus, a key recommendation for future use of the CM-TAM is the development of additional items that are designed to target observed gaps in the scale. Further, because the ultimate value of a fidelity measure is its ability to predict outcomes, future investigation should assess the links between the CM adherence components and key outcomes for the client, such as drug use, criminal charge, and behavioral outcomes. The details of the MFRM model used in this study are described. 3 figures and 36 references