Five decades of randomized trials research have produced dozens of evidence-based psychotherapies (EBPs) for youths. The EBPs produce respectable effects in traditional efficacy trials, but the effects shrink markedly when EBPs are tested in practice contexts with clinically referred youths and compared to usual clinical care. We considered why…

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…

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.…