Despite great advancements in the development of evidence-based treatments (EBTs) for youth mental health problems, few EBTs have been adopted by or successfully implemented in schools. This is of concern, as schools are the most common entry point for youth mental health services. Modular psychotherapies may be a particularly good fit for the…

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…

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: 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…

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…

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.…

In the debate over evidence-based treatments (EBTs) for youth, one question is central: Do EBTs produce better outcomes than the usual interventions employed in clinical care? The authors addressed this question through a meta-analysis of 32 randomized trials that directly compared EBTs with usual care. EBTs outperformed usual care. Effects fell…

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…

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…

The major youth psychotherapy meta-analyses have relied on published studies, which may have led to biased effect size estimates. To examine this possibility, the authors compared 121 dissertations with 134 published studies and found the following: (a) few differences on individual methodological variables, but, overall, stronger methodology in…

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…

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…

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…