The American Psychological Association Task Force on Evidence- Based Practice for Children and Adolescents (2008) recommended a systems approach to enhancing care in order to improve outcomes for children and adolescents with mental health needs and redress persistent systemic problems with the structure of services. Recommendations for enhancing…

Most everyday child and adolescent psychotherapy does not follow manuals that document the procedures. Consequently, usual clinical care has remained poorly understood and rarely studied. The Therapy Process Observational Coding System for Child Psychotherapy-Strategies scale (TPOCS-S) is an observational measure of youth psychotherapy procedures…

Objective: Some critics of treatment manuals have argued that their use may undermine the quality of the client-therapist alliance. This notion was tested in the context of youth psychotherapy delivered by therapists in community clinics. Method: Seventy-six clinically referred youths (57% female, age 8-15 years, 34% Caucasian) were randomly…

Serious sequelae of youth depression, plus recent concerns over medication safety, prompt growing interest in the effects of youth psychotherapy. In previous meta-analyses, effect sizes (ESs) have averaged 0.99, well above conventional standards for a large effect and well above mean ES for other conditions. The authors applied rigorous analytic…

Objective: The dynamics of interactions between evidence-based intervention (EBI) developers and trainers and organizations and providers that deliver the EBI was examined in two case studies, a statewide randomized effectiveness trial of an EBI to reduce child neglect and a randomized trial of EBIs for depression, anxiety, and conduct problems in…

Compared 93 children and adolescents who completed psychotherapy with 60 who dropped out after intake. At intake, groups did not differ on demographic, family, or clinical measures, including Child Behavior Checklist (CBCL) scores. Six months and one year later, groups were compared again. No comparison showed significant main effects of therapy.…

Conducted meta-analysis of 108 well-designed outcome studies using 4- through 18-year-old subjects to examine effectiveness of psychotherapy with children and adolescents. Overall, findings revealed significant, durable effects of treatment that differed somewhat with client age and treatment method but which were reliably greater than zero for…

Eight- to 17-year-olds referred for outpatient therapy reported contingency, competence, and control beliefs about solving problems at home and school. Parents completed the Child Behavior Checklist before and after psychotherapy. Perceived contingency and perceived control accounted for 29% of the variance in total problem reduction, indicating…

Obtained reports of coping and goals from 33 children being treated for leukemia. Coping strategies were classified as primary control coping (attempts to alter objective conditions), secondary control coping (attempts to adjust to objective conditions), or relinquished control (no attempt to cope). Secondary control coping was positively…

In studies of the usefulness of psychotherapy with children and adolescents, clinical therapy has markedly poorer outcomes than laboratory studies. Proposals to bridge the gap include enriching the data base on treatment effects by clinical practitioners, identifying the features of research therapy that account for positive outcomes, and…

Compared Thailand to United States in regard to children's psychological problems and corresponding clinic referral patterns. Overcontrolled problems (somaticizing, fearfulness, nervous movements, worrying) were reported more often for Thai than for American youth. Undercontrolled problems (disobedience, fighting, lying, arguing) were reported…

Evaluated the hypothesis that the apparent superiority of behavioral interventions among children is due to differences in the methodological quality of studies of behavioral and nonbehavioral treatments. Meta-analytic results found little support for this hypothesis. Because meta-analysis is a correlational technique, these results should be…

Studied six- to 17-year-old outpatients who completed intake but did not enter therapy with those in therapy for an average of 13 sessions. Compared groups on demographics, Child Behavior Checklist broadband and narrow-band syndrome scores, Children's Depression Inventory scores, therapist age and sex, and on parent perceptions of clinic and…

The Revised Child Anxiety and Depression Scale-Parent Version (RCADS-P) is a 47-item parent-report questionnaire of youth anxiety and depression, with scales corresponding to the DSM-IV categories of Separation Anxiety Disorder, Social Phobia, Generalized Anxiety Disorder (GAD), Panic Disorder, Obsessive-Compulsive Disorder, and Major Depressive…

Objective: To complement standardized measurement of symptoms, we developed and tested an efficient strategy for identifying (before treatment) and repeatedly assessing (during treatment) the problems identified as most important by caregivers and youths in psychotherapy. Method: A total of 178 outpatient-referred youths, 7-13 years of age, and…