John R Weisz

Harvard University, Cambridge, MA, United States

Are you John R Weisz?

Claim your profile

Publications (175)762.12 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: Research has examined the effects of parental psychopathology, family functioning, and caregiver strain on treatment response in anxious youths. Although these variables have shown individual links to youth treatment response, theoretical models for their combined effects remain unexplored. This study tested the hypothesis that improvements in family functioning and reductions in caregiver strain explained the effects of parental psychopathology on youth treatment outcome in an anxiety treatment trial. Method: A multiple mediation technique was used to test the proposed model across independent evaluator (IE), parent, and youth informants in 488 youths, aged 7-17 years (50% female; mean age = 10.7) meeting Diagnostic and Statistical Manual of Mental Disorders criteria for social phobia, separation anxiety, and/or generalized anxiety disorder. Youths were randomized to receive 12 weeks of cognitive-behavioral treatment (Coping Cat), medication (sertraline), their combination, or a pill placebo. At pre- and posttreatment, parents completed self-report measures of global psychopathology symptoms, family functioning, and caregiver strain; parents, youths, and IEs rated youths' anxiety symptom severity. Results: Changes in family functioning and caregiver strain jointly explained relations between parental psychopathology and reductions in youth anxiety. Specifically, across IE and parent informants, families with higher pretreatment parental psychopathology showed more improvement in family functioning and caregiver strain, which in turn predicted greater youth anxiety reductions. Further, higher pretreatment parental psychopathology predicted greater caregiver strain reductions and, in turn, greater youth anxiety reductions, based on youths' reports of their own anxiety. Conclusions: Findings suggest that improvements in family functioning and reductions in caregiver strain can influence treatment outcomes for anxious youths, especially among youths with more distressed parents. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
    Journal of Consulting and Clinical Psychology 09/2014; · 4.85 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Pediatric inflammatory bowel disease (IBD) is associated with high rates of depression. This study compared the efficacy of cognitive behavioral therapy (CBT) to supportive nondirective therapy (SNDT) in treating youth with comorbid IBD and depression.
    Journal of the American Academy of Child and Adolescent Psychiatry 07/2014; 53(7):726-35. · 6.97 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Parent-teacher cross-informant agreement, although usually modest, may provide important clinical information. Using data for 27,962 children from 21 societies, we asked the following: (a) Do parents report more problems than teachers, and does this vary by society, age, gender, or type of problem? (b) Does parent-teacher agreement vary across different problem scales or across societies? (c) How well do parents and teachers in different societies agree on problem item ratings? (d) How much do parent-teacher dyads in different societies vary in within-dyad agreement on problem items? (e) How well do parents and teachers in 21 societies agree on whether the child's problem level exceeds a deviance threshold? We used five methods to test agreement for Child Behavior Checklist (CBCL) and Teacher's Report Form (TRF) ratings. CBCL scores were higher than TRF scores on most scales, but the informant differences varied in magnitude across the societies studied. Cross-informant correlations for problem scale scores varied moderately across societies studied and were significantly higher for Externalizing than Internalizing problems. Parents and teachers tended to rate the same items as low, medium, or high, but within-dyad item agreement varied widely in every society studied. In all societies studied, both parental noncorroboration of teacher-reported deviance and teacher noncorroboration of parent-reported deviance were common. Our findings underscore the importance of obtaining information from parents and teachers when evaluating and treating children, highlight the need to use multiple methods of quantifying cross-informant agreement, and provide comprehensive baselines for patterns of parent-teacher agreement across 21 societies.
    Journal of Clinical Child & Adolescent Psychology 04/2014; · 1.92 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: This study tested whether family income and stress in the parent-youth relationship might mediate links between parent symptoms and youth problems, and whether the process might differ for youth externalizing versus internalizing problems. We used a multiple mediation technique to test pathways by which family income and stress in the parent-child relationship might relate to parent-youth symptom associations in a sample of clinically-referred 7-13 year-olds (32 % female; M age = 10.16 years). Family income and stress jointly mediated the relation between parent symptoms and youth externalizing problems but not between parent symptoms and youth internalizing problems. Future longitudinal research should investigate whether low income and parent-youth stress may deplete the parental resources needed to manage youth externalizing behavior. This study extends existing literature by suggesting a specific pattern by which two identified risk factors for youth problems may operate jointly, and by showing specificity to externalizing problems.
    Child Psychiatry and Human Development 02/2014; · 1.93 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Links between parents' psychiatric symptoms and their children's behavioral and emotional problems have been widely documented in previous research, and the search for moderators of this association has begun. However, family structure (single versus dual-parent households) has received little attention as a potential moderator, despite indirect evidence that risk may be elevated in single-parent homes. Two other candidate moderators-youth gender and age-have been tested directly, but with inconsistent findings across studies, perhaps in part because studies have differed in whether they used youth clinical samples and in which informants (parents vs. youths) reported on youth problems. In the present study, we examined these three candidate moderators using a sample of exclusively clinic-referred youths (N = 333, 34 % girls, aged 7-14,) and assessing youth problems through both parent- and youth-reports. Both family structure and youth gender emerged as robust moderators across parent and youth informants. Parent symptoms were associated with youth internalizing and externalizing problems in single-parent but not dual-parent homes; and parent symptoms were associated with youth internalizing problems among boys, but not girls. The moderator findings suggest that the risks associated with parent psychopathology may not be uniform but may depend, in part, on family structure and youth gender.
    Journal of Abnormal Child Psychology 02/2014; 42:195-204. · 3.09 Impact Factor
  • John R. Weisz, Mei Yi Ng, Sarah Kate Bearman
    [Show abstract] [Hide abstract]
    ABSTRACT: Decades of clinical psychological science have produced empirically supported treatments that are now undergoing dissemination and implementation (DI) but with little guidance from a science that is just taking shape. Charting a future for DI science (DIS) and DI practice (DIP), and their complex relationship, will be complicated by significant challenges—the implementation cliff (intervention benefit drops when tested practices are scaled up), low relevance of most clinical research to actual practice, and differing timetables and goals for DIP versus DIS. To address the challenges, and prepare the next generation of clinical psychological scientists, we propose the following: making intervention research look more like practice, solving the “too many empirically supported treatments” problem, addressing mismatches between interventions and their users (e.g., clients, therapists), broadening the array of intervention delivery systems, sharpening outcome monitoring and feedback, incentivizing high-risk/high-gain innovations, designing new professional tracks, and synchronizing and linking the often-insular practice and science of DI.
    Clinical Psychological Science. 01/2014; 2(1):58-74.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This study examined the psychometric properties of the DSM-oriented scales of the Child Behavior Checklist (Achenbach, Dumenci, & Rescorla, 2003) using confirmatory factor analysis to compare the six-factor structure of the DSM-oriented scales to competing models consistent with developmental theories of symptom differentiation. We tested these models on both clinic-referred (N = 757) and school-based, nonreferred (N = 713) samples of youths in order to assess the generalizability of the factorial structures. Although previous research has supported the fit of the six-factor DSM-oriented structure in a normative sample of youths ages 7 to 18 (Achenbach & Rescorla, 2001), tripartite model research indicates that anxiety and depressive symptomology are less differentiated among children compared to adolescents (Jacques & Mash, 2004). We thus examined the relative fit of a six- and a five-factor model (collapsing anxiety and depression) with younger (ages 7-10) and older (ages 11-18) youth subsamples. The results revealed that the six-factor model fit the best in all samples except among younger nonclinical children. The results extended the generalizability of the rationally derived six-factor structure of the DSM-oriented scales to clinic-referred youths and provided further support to the notion that younger children in nonclinical samples exhibit less differentiated symptoms of anxiety and depression.
    Development and Psychopathology 11/2013; 25(4pt1):1005-1015. · 4.40 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: This article reports outcomes from the Child STEPs randomized effectiveness trial conducted over a 2-year period to gauge the longer term impact of protocol design on the effectiveness of evidence-based treatment procedures. Method: An ethnoracially diverse sample of 174 youths ages 7- 13 (N = 121 boys) whose primary clinical concerns involved diagnoses or clinical elevations related to anxiety, depression, or disruptive behavior were treated by community therapists randomly assigned to 1 of 3 conditions: (a) standard, which involved the use of 1 or more of 3 manualized evidence-based treatments, (b) modular, which involved a single modular protocol (Modular Approach to Treatment of Children With Anxiety, Depression, or Conduct Problems; MATCH) having clinical procedures similar to the standard condition but flexibly selected and sequenced using a guiding clinical algorithm, and (c) usual care. Results: As measured with combined Child Behavior Checklist and Youth Self-Report Total Problems, Internalizing, and Externalizing scales, the rate of improvement for youths in the modular condition was significantly better than for those in usual care. On a measure of functional impairment (Brief Impairment Scale), no significant differences were found among the 3 conditions. Analysis of service utilization also showed no significant differences among conditions, with almost half of youths receiving some additional services in the 1st year after beginning treatment, and roughly one third of youths in the 2nd year. Conclusions: Overall, these results extend prior findings, supporting incremental benefits of MATCH over usual care over a 2-year period. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
    Journal of Consulting and Clinical Psychology 08/2013; · 4.85 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Evidence-based treatments for child mental health problems are not consistently available in public mental health settings. Expanding availability requires workforce training. However, research has demonstrated that training alone is not sufficient for changing provider behavior, suggesting that ongoing intervention-specific supervision or consultation is required. Supervision is notably under-investigated, particularly as provided in public mental health. The degree to which supervision in this setting includes 'gold standard' supervision elements from efficacy trials (e.g., session review, model fidelity, outcome monitoring, skill-building) is unknown. The current federally-funded investigation leverages the Washington State Trauma-focused Cognitive Behavioral Therapy Initiative to describe usual supervision practices and test the impact of systematic implementation of gold standard supervision strategies on treatment fidelity and clinical outcomes.Methods/design: The study has two phases. We will conduct an initial descriptive study (Phase I) of supervision practices within public mental health in Washington State followed by a randomized controlled trial of gold standard supervision strategies (Phase II), with randomization at the clinician level (i.e., supervisors provide both conditions). Study participants will be 35 supervisors and 130 clinicians in community mental health centers. We will enroll one child per clinician in Phase I (N = 130) and three children per clinician in Phase II (N = 390). We use a multi-level mixed within- and between-subjects longitudinal design. Audio recordings of supervision and therapy sessions will be collected and coded throughout both phases. Child outcome data will be collected at the beginning of treatment and at three and six months into treatment. This study will provide insight into how supervisors can optimally support clinicians delivering evidence-based treatments. Phase I will provide descriptive information, currently unavailable in the literature, about commonly used supervision strategies in community mental health. The Phase II randomized controlled trial of gold standard supervision strategies is, to our knowledge, the first experimental study of gold standard supervision strategies in community mental health and will yield needed information about how to leverage supervision to improve clinician fidelity and client outcomes.Trial registration: NCT01800266.
    Implementation Science 08/2013; 8(1):89. · 2.37 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: OBJECTIVE This study examined the extent to which therapists who participated in a randomized controlled trial (RCT) of evidence-based treatments continued to use them with nonstudy clients after the trial as well as the types of treatment used and the reasons for their continued use. METHODS Semistructured interviews and focus groups were conducted with 38 therapists, three clinical supervisors, and eight clinic directors three months after an RCT of evidence-based treatments for depression, anxiety, and conduct disorders among children and adolescents. The therapists had been assigned randomly to one of three conditions: modular (N=15), allowing flexible use and informed adaptations of treatment components; standard (N=13), using full treatment manuals; and usual care (N=10). Grounded-theory analytic methods were used to analyze interview transcripts. RESULTS Twenty-six therapists (93%) assigned to the modular or standard condition used the treatments with nonstudy cases. Of those, 24 (92%) therapists, including all but two assigned to the standard condition, reported making some adaptation or modification, including using only some modules with all clients or all modules with some clients; changing the order or presentation of the modules to improve the flow or to work around more immediate issues; and using the modules with others, including youths with co-occurring disorders, youths who did not meet the age criteria, and adults. CONCLUSIONS The results provide insight into the likely sustainability of evidence-based treatments, help to explain why the outcomes of the RCT favored a modular approach, and highlight the strengths and limitations of use of evidence-based treatments.
    Psychiatric services (Washington, D.C.) 08/2013; · 2.81 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Sudden gains have been described as rapid, sizeable changes observed between treatment sessions and have been associated with improved treatment outcome in adults. The current study examined weekly sudden gains among children seeking treatment in the community mental health setting. Participants were 161 children (age M = 10.58, SD = 1.73; 69.6% male; 47.8% Caucasian) and their parents who were randomized to one of three treatment modalities and were administered weekly and quarterly assessments throughout treatment. When idiographic (youth- and parent-identified "top problems") and nomothetic measures (standardized checklists) were used to calculate sudden gains (i.e., gain must be large: in absolute terms, relative to prior session, and relative to changes in prior and subsequent sessions), 20-42% of participants experienced at least one sudden gain during treatment. Most sudden gains occurred early in treatment, and session content of relaxation was associated with sudden gain presence. Using a modified Bonferonni correction, sudden gains predicted overall symptom levels at final assessment (i.e., last assessment obtained following post-treatment) even after controlling for pre-treatment symptom levels and magnitude of the overall gain from pre- to post-treatment. Suddenness of gains may have a direct effect on long-term treatment outcome among children in the community.
    Behaviour Research and Therapy 06/2013; 51(9):564-572. · 3.85 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: IMPORTANCE Research across more than 4 decades has produced numerous empirically tested evidence-based psychotherapies (EBPs) for psychopathology in children and adolescents. The EBPs were developed to improve on usual clinical interventions. Advocates argue that the EBPs should replace usual care, but this assumes that EBPs produce better outcomes than usual care. OBJECTIVE To determine whether EBPs do in fact produce better outcomes than usual care in youth psychotherapy. We performed a meta-analysis of 52 randomized trials directly comparing EBPs with usual care. Analyses assessed the overall effect of EBPs vs usual care and candidate moderators; we used multilevel analysis to address the dependency among effect sizes (ES) that is common but typically unaddressed in psychotherapy syntheses. DATA SOURCES We searched the PubMed, PsychINFO, and Dissertation Abstracts International databases for studies from January 1, 1960, through December 31, 2010. STUDY SELECTION We identified 507 randomized youth psychotherapy trials. Of these, the 52 studies that compared EBPs with usual care were included in the meta-analysis. DATA EXTRACTION AND SYNTHESIS Sixteen variables (participant, treatment, outcome, and study characteristics) were extracted from studies, and ESs were calculated for all comparisons of EBP vs usual care. We used an extension of the commonly used random-effects meta-analytic model to obtain an overall estimate of the difference between EBP and usual care while accounting for the dependency among ESs. We then fitted a 3-level mixed-effects model to identify moderators that might explain variation in ESs within and between studies by adding study or ES characteristics as fixed predictors. MAIN OUTCOMES AND MEASURES Primary outcomes of our meta-analysis were mean ES estimates across all studies and for levels of candidate moderators. These ES values were based on measures of symptoms, functioning, and other outcomes assessed within the 52 randomized trials. RESULTS Evidence-based psychotherapies outperformed usual care. Mean ES was 0.29; the probability was 58% that a randomly selected youth would have a better outcome after EBP than a randomly selected youth after receiving usual care. The following 3 variables moderated treatment benefit: ESs decreased for studies conducted outside North America, for studies in which all participants were impaired enough to qualify for diagnoses, and for outcomes reported by informants other than the youths and parents in therapy. For certain key groups (eg, studies of clinically referred samples and youths with diagnoses), significant EBP effects were not demonstrated. CONCLUSIONS AND RELEVANCE Evidence-based psychotherapies outperform usual care, but the EBP advantage is modest and moderated by youth, location, and assessment characteristics. The EBPs have room for improvement in the magnitude and range of their benefit relative to usual clinical care.
    JAMA Psychiatry 05/2013; · 12.01 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Identifying predictors of evidence-based practice (EBP) use, such as supervision processes and therapist characteristics, may support dissemination. Therapists (N = 57) received training and supervision in EBPs to treat community-based youth (N = 136). Supervision involving modeling and role-play predicted higher overall practice use than supervision involving discussion, and modeling predicted practice use in the next therapy session. No therapist characteristics predicted practice use, but therapist sex and age moderated the supervision and practice use relation. Supervision involving discussion predicted practice use for male therapists only, and modeling and role-play in supervision predicted practice use for older, not younger, therapists.
    Administration and Policy in Mental Health and Mental Health Services Research 03/2013; · 3.44 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: 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 this might be the case. We examined relevant research literature and drew examples from our own research in practice settings. One reason for the falloff in EBP effects may be that so little youth treatment research has been done in the context of everyday practice. Researchers may have missed opportunities to learn how to make EBPs work well in the actual youth mental health ecosystem, in which so many real-world factors are at play that cannot be controlled experimentally. We sketch components and characteristics of that ecosystem, including clinically referred youths, their caregivers and families, the practitioners who provide their care, the organizations within which care is provided, the network of youth service systems (e.g., child welfare, education), and the policy context (e.g., reimbursement regulations and incentives). We suggest six strategies for future research on EBPs within the youth mental health ecosystem, including reliance on the deployment-focused model of development and testing, testing the mettle of current EBPs in everyday practice contexts, using the heuristic potential of usual care, testing restructured and integrative adaptations of EBPs, studying the use of treatment response feedback to guide clinical care, and testing models of the relation between policy change and EBP implementation.
    Journal of Clinical Child & Adolescent Psychology 03/2013; 42(2):274-86. · 1.92 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Due to increased multiculturalism in the US and abroad, there is a need for increased understanding of the different ways in which parenting stress is related to child problems across cultures. In the present study, we investigated (a) differences in reported parenting stress and childhood problem behaviors across a Korean (n = 71) and US (n = 71) sample, as well as (b) differences in the ways in which parenting stress and childhood problems were related across Korean and US children based on mothers' reports. Results revealed that Korean mothers reported significantly higher parenting stress yet significantly lower childhood problem behaviors compared to US mothers. In addition, mother-based reports of child problems were significantly associated with parenting stress in the US sample, but not in the Korean sample. Clinical implications and culturally-relevant issues relevant to these findings are addressed, including a potential under-reporting bias of child problems among Asian parents.
    Child Psychiatry and Human Development 10/2012; · 1.93 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: This study sought to evaluate the agreement between therapist report and coder observation of therapy practices. The study sampled session data from a community-based, randomized trial of treatment for youth ages 7 to 13. We used therapist report of session content and coverage gathered using formal Consultation Records and developed complimentary records for coders to use when watching or listening to therapy tape. We established initial reliability between coders and then conducted a random, stratified, and comprehensive sample of sessions across youth (N = 121), therapists (N = 57), conditions (MATCH and Standard Manuals), and study sites (Honolulu and Boston) to code and compare with therapist record reports. Intraclass correlation coefficients (ICCs) representing coder versus therapist agreement on manual content delivered ranged from .42 to 1.0 across conditions and problem areas. Analyses revealed marked variability in agreement regarding whether behavioral rehearsals took place (ICCs from -.01 to 1.0) but strong agreement on client comprehension of therapy content and homework assignments. Overall, the findings indicate that therapists can be accurate reporters of the therapeutic practices they deliver, although they may need more support in reporting subtle but valuable aspects of implementation such as types of behavioral rehearsals. Developing means to support accurate reporting is important to developing future clinical feedback methodology applicable to the implementation of evidence-based treatments in the real world.
    Journal of Clinical Child & Adolescent Psychology 07/2012; · 1.92 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Using a school-based (N = 1,060) and clinic-referred (N = 303) youth sample, the authors developed a 25-item shortened version of the Revised Child Anxiety and Depression Scale (RCADS) using Schmid-Leiman exploratory bifactor analysis to reduce client burden and administration time and thus improve the transportability characteristics of this youth anxiety and depression measure. Results revealed that all anxiety items primarily reflected a single "broad anxiety" dimension, which informed the development of a reduced 15-item Anxiety Total scale. Although specific DSM-oriented anxiety subscales were not included in this version, the items comprising the Anxiety Total scale were evenly pulled from the 5 anxiety-related content domains from the original RCADS. The resultant 15-item Anxiety Total scale evidenced significant correspondence with anxiety diagnostic groups based on structured clinical interviews. The scores from the 10-item Depression Total scale (retained from the original version) were also associated with acceptable reliability in the clinic-referred and school-based samples (α = .80 and .79, respectively); this is in contrast to the alternate 5-item shortened RCADS Depression Total scale previously developed by Muris, Meesters, and Schouten (2002), which evidenced depression scores of unacceptable reliability (α = .63). The shortened RCADS developed in the present study thus balances efficiency, breadth, and scale score reliability in a way that is potentially useful for repeated measurement in clinical settings as well as wide-scale screenings that assess anxiety and depressive problems. These future applications are discussed, as are recommendations for continued use of exploratory bifactor modeling in scale development. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
    Psychological Assessment 02/2012; · 2.99 Impact Factor
  • Sarah Kate Bearman, John R. Weisz
    01/2012: pages 1-28;
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Decades of randomized controlled trials have produced separate evidence-based treatments for depression, anxiety, and conduct problems in youth, but these treatments are not often used in clinical practice, and they produce mixed results in trials with the comorbid, complex youths seen in practice. An integrative, modular redesign may help. Standard/separate and modular/integrated arrangements of evidence-based treatments for depression, anxiety, and conduct problems in youth were compared with usual care treatment, with the modular design permitting a multidisorder focus and a flexible application of treatment procedures. Randomized effectiveness trial. Ten outpatient clinical service organizations in Massachusetts and Hawaii. A total of 84 community clinicians were randomly assigned to 1 of 3 conditions for the treatment of 174 clinically referred youths who were 7 to 13 years of age (70% of these youths were boys, and 45% were white). The study was conducted during the period from January 12, 2005 to May 8, 2009. Standard manual treatment (59 youths [34% of the sample]; cognitive behavioral therapy for depression, cognitive behavioral therapy for anxiety, and behavioral parent training for conduct problems), modular treatment (62 youths [36%]; integrating the procedures of the 3 separate treatments), and usual care (53 youths [30%]). Outcomes were assessed using weekly youth and parent assessments. These assessments relied on a standardized Brief Problem Checklist and a patient-generated Top Problems Assessment (ie, the severity ratings on the problems that the youths and parents had identified as most important). We also conducted a standardized diagnostic assessment before and after treatment. Mixed effects regression analyses showed that modular treatment produced significantly steeper trajectories of improvement than usual care and standard treatment on multiple Brief Problem Checklist and Top Problems Assessment measures. Youths receiving modular treatment also had significantly fewer diagnoses than youths receiving usual care after treatment. In contrast, outcomes of standard manual treatment did not differ significantly from outcomes of usual care. The modular approach outperformed usual care and standard evidence-based treatments on multiple clinical outcome measures. The modular approach may be a promising way to build on the strengths of evidence-based treatments, improving their utility and effectiveness with referred youths in clinical practice settings. Trial Registration Identifier: NCT01178554.
    Archives of general psychiatry 11/2011; 69(3):274-82. · 12.26 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Current evidence-based assessment methods, such as structured interviews and lengthy assessment batteries, often require hours to administer, score, and interpret and thus are infrequently used in real-world practice. As evidence-based assessment tools are developed for implementation in real-world youth mental health settings, the transportability properties of assessment procedures (including administration and interpretation burden) need to be considered and improved. In the present study, we thus conducted an initial feasibility study using a clinical sample of community-based youths (N = 306) to develop an assessment protocol based on 2 child and 2 parent self-report questionnaires (thus low on administration burden). Using decision-tree analysis, we identified a series of cutoff scores across these scales that may be used to inform treatment need related to anxiety, depression, attention-deficit/hyperactivity disorder (ADHD), and disruptive behavior problems. This algorithm-based approach to interpreting assessment information provided clear and simple guidelines (thus low on interpretation burden) that matched the best estimate treatment determinations derived by trained assessors, supervisors, and expert consultants who integrated information provided by child and parent structured interviews and self-report scales. The present study demonstrated the feasibility of developing an assessment protocol to inform various treatment allocation decisions in a way that imposes little assessment administration and interpretation burden yet maintains adequate classification accuracy. These characteristics make the proposed protocol promising with regard to its transportability and suitability for adoption and implementation in real-world mental health settings.
    Psychological Assessment 08/2011; 24(1):141-55. · 2.99 Impact Factor

Publication Stats

8k Citations
762.12 Total Impact Points


  • 2005–2014
    • Harvard University
      • Department of Psychology
      Cambridge, MA, United States
  • 2013
    • University of Hawaiʻi at Hilo
      • Department of Psychology
      Hilo, Hawaii, United States
  • 2004–2013
    • University of Washington Seattle
      • • Department of Psychology
      • • Department of Pediatrics
      Seattle, Washington, United States
  • 1991–2013
    • University of California, Los Angeles
      • Department of Psychology
      Los Angeles, California, United States
  • 2010
    • University of Miami
      • Department of Psychology
      Coral Gables, FL, United States
  • 2005–2010
    • Virginia Commonwealth University
      • • Department of Psychology
      • • Department of Psychiatry
      Richmond, VA, United States
  • 2005–2009
    • University of Hawaiʻi at Mānoa
      • Department of Psychology
      Honolulu, HI, United States
  • 2008
    • Medical University of South Carolina
      • Department of Psychiatry and Behavioral Sciences
      Charleston, SC, United States
    • Harvard Medical School
      • Judge Baker Children's Center
      Boston, MA, United States
  • 2006–2008
    • Texas A&M University
      • Department of Educational Psychology
      College Station, TX, United States
  • 1997–2008
    • University of Southern California
      • School of Social Work
      Los Angeles, CA, United States
    • Northwestern Memorial Hospital
      Chicago, Illinois, United States
  • 1991–2006
    • Vanderbilt University
      • Department of Psychology and Human Development
      Nashville, Michigan, United States
  • 2002
    • Western Psychiatric Institute and Clinic
      Pittsburgh, Pennsylvania, United States
  • 2000
    • Washington University in St. Louis
      • George Warren Brown School of Social Work
      Saint Louis, MO, United States
  • 1994–2000
    • Tufts University
      • Department of Child Development
      Medford, MA, United States
  • 1998
    • Yale University
      • Department of Psychology
      New Haven, CT, United States
  • 1996–1997
    • University of Illinois at Chicago
      • Institute for Juvenile Research
      Chicago, Illinois, United States
  • 1989–1991
    • University of North Carolina at Chapel Hill
      • Department of Psychology
      North Carolina, United States