First, fidelity scales have been developed for program- and practitioner-level implementation (2), but I had not previously seen a measure of client-specific implementation. Additionally, as conceptualized by Falloon and colleagues, high fidelity requires evidence that the client incorporates the intervention into real-life settings. Initially, I viewed the authors' assumption as conflicting with our operational definition, which states that fidelity should be confined to actions that are under the clinician's control (3). Upon reflection, I concluded that responsibility for attaining real-world implementation should be shared by the clinician and the client. For example, our fidelity scales do not attribute treatment dropout to lack of motivation. Instead, dropout often reflects a lack of assertive outreach.