Evidence-Based Practice in Child and Adolescent Mental Health Services

Duke University, Durham, North Carolina, United States
Psychiatric Services (Impact Factor: 2.41). 10/2001; 52(9):1179-89. DOI: 10.1176/
Source: PubMed


The authors review the status, strength, and quality of evidence-based practice in child and adolescent mental health services. The definitional criteria that have been applied to the evidence base differ considerably across treatments, and these definitions circumscribe the range, depth, and extensionality of the evidence. The authors describe major dimensions that differentiate evidence-based practices for children from those for adults and summarize the status of the scientific literature on a range of service practices. The readiness of the child and adolescent evidence base for large-scale dissemination should be viewed with healthy skepticism until studies of the fit between empirically based treatments and the context of service delivery have been undertaken. Acceleration of the pace at which evidence-based practices can be more readily disseminated will require new models of development of clinical services that consider the practice setting in which the service is ultimately to be delivered.

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    • "A growing body of research has emerged to suggest that organizational factors are important contextual characteristics that impact delivery of mental health services for youth in community settings (Glisson & James, 2002; Glisson et al., 2010; Hoagwood, Burns, Kiser, Heather, & Schoenwald, 2001). This research draws upon the organizational literature which suggests the importance of an individual's social context on one's attitudes, beliefs, and subsequent behavior around adoption of innovation (Glisson, 2002; Rogers, 2003). "
    Oxford Handbooks Online, Edited by P. Nathan, 09/2015; Oxford University Press.
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    • "Importantly, the vast majority of studies testing evidence-based parenting-and family-focused interventions targeting disruptive behavior in youth have been efficacy trials prioritizing internal validity of the study (e.g., does the intervention work?). Unfortunately, these types of trials typically have limited external validity (e.g., is the intervention generalizable?) to the typical practice context, given the differences in patient, therapist, and setting characteristics (Hoagwood et al. 2001). The current effectiveness study focuses on the extent to which a treatment can work in applied practice settings. "
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    ABSTRACT: This paper reports on the 6-month follow-up outcomes of an effectiveness study testing a multiple family group (MFG) intervention for clinic-referred youth (aged 7–11) with disruptive behavior disorders (DBDs) and their families in socioeconomically disadvantaged families compared to services-as-usual (SAU) using a block comparison design. The settings were urban community-based outpatient mental health agencies. Clinic-based providers and family partner advocates facilitated the MFG intervention. Parent-report measures targeting child behavior, social skills, and impairment across functional domains (i.e., relationships with peers, parents, siblings, and academic progress) were assessed across four timepoints (baseline, mid-test, post-test, and 6-month follow-up) using mixed effects regression modeling. Compared to SAU participants, MFG participants reported significant improvement at 6-month follow-up in child behavior, impact of behavior on relationship with peers, and overall impairment/need for services. Findings indicate that MFG may provide longer-term benefits for youth with DBDs and their families in community-based settings. Implications within the context of a transforming healthcare system are discussed.
    Journal of Child and Family Studies 12/2014; 24(9). DOI:10.1007/s10826-014-0074-6 · 1.42 Impact Factor
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    • "ESIs are typically tested in highly controlled conditions that seek to isolate an intervention's effect by factoring out certain ''nuisance variables,'' such as comorbidity. These ''nuisance variables,'' however, may be important to the success of an intervention in real-world agency practice (Hoagwood et al. 2001). Further, some clinicians believe ESIs are too rigid, thus precluding flexibility and practice wisdom (Chambless and Ollendick 2001). "
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    ABSTRACT: Evidence-based practice (EBP) is increasingly emphasized in social work, yet effective approaches for translating research evidence into social work practice remain elusive. Despite a growing body of evidence describing effective interventions with a variety of populations, social workers continue to encounter substantial challenges with incorporating knowledge gained from these intervention studies into their routine practice with clients. This paper presents the current research outlining the known barriers and promoters to using EBP in social work clinical practice. Because social workers practice within the context of organizations, we consider the barriers that exist at both the individual and organizational levels that affect clinical social work practice. In addition to addressing the various challenges to incorporating research evidence into practice, we will also discuss a variety of emergent opportunities accompanying the move toward EBP that can be leveraged by clinicians in their social work practice with clients.
    Clinical Social Work Journal 04/2014; 42(2). DOI:10.1007/s10615-014-0492-3 · 0.27 Impact Factor
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