Bryce D McLeod

Verified

Bryce verified their affiliation via an institutional email.

Learn more

Verified

Bryce verified their affiliation via an institutional email.

Learn more

• PhD
• Professor at Virginia Commonwealth University

The interpretation of effectiveness research can be enhanced by understanding what prescribed (i.e., adherence) and non-prescribed (i.e., differentiation) techniques were delivered. However, few measures exist that can assess both adherence and differentiation. The current study examined how the Therapy Process Observational Coding System for Child...

It is difficult for consumers to access the evidence base for prevention programs to determine which models or practices have the strongest empirical support for improving youth social, emotional, and behavioral (SEB) outcomes within their specific service contexts. Researchers can address this evidence-to-practice gap through innovations in resear...

[This corrects the article DOI: 10.1371/journal.pone.0285949.].

This article presents initial psychometric data for scores on the Child Responsiveness Scale (CRS), an observational measure to assess child responsiveness to teacher delivery of practices designed to promote social-emotional competencies. In Study 1, 633 live observations conducted with 54 teachers and 91 children at risk for emotional and behavio...

Knowledge about how to enhance group cognitive behavioral therapy (GCBT) outcomes is needed. In a randomized controlled effectiveness trial, we examined group cohesion (the bond between group members) and the alliance (the client-clinician bond) as predictors of GCBT outcomes. The sample was 88 youth (M age 11.7 years, SD = 2.1; 54.5% girls; 90.7%...

Objective: The current observational study examined shared decision-making (SDM) with caregivers of Latinx youth within the delivery of multiple evidence-based practices (EBPs) in community mental health services. The aims of the study were to (1) Identify therapist and client factors associated with increased SDM within EBP sessions and (2) Exami...

The current study was designed to describe usual clinical care for youth with primary anxiety problems in community mental health centers. The observer-rated Therapy Process Observational Coding System for Child Psychotherapy – Revised Strategies scale (TPOCS-RS), designed to assess therapeutic techniques from five theory-based domains, was used to...

The quality of care in public schools and other community settings for school-aged youths on the autism spectrum is variable and often not evidence-based. Training practitioners in these settings to deliver evidence-based practices (EBPs) may improve the quality of care. We developed a free internet-based training and clinical guidance system synth...

Introduction Due to usability, feasibility, and acceptability concerns, observational treatment fidelity measures are often challenging to deploy in schools. Teacher self-report fidelity measures with specific design features might address some of these barriers. This case study outlines a community-engaged, iterative process to adapt the observati...

Background Providing high-quality early childhood care and education is understood as key to maximizing children’s potential to succeed later in life, as it stimulates young children’s development of skills and competencies needed to promote optimal outcomes and success later in life. Despite the government’s efforts to support the early childhood...

Problem-solving (PS) has been identified as a therapeutic technique found in multiple evidence-based treatments for depression. To further understand for whom and how this intervention works, we undertook a systematic review of the evidence for PS’s effectiveness in preventing and treating depression among adolescents and young adults. We searched...

Student responsiveness's role in promoting intervention outcomes for students who exhibit problem behavior is understudied. Due to the relational nature of many interventions delivered by teachers that target social, emotional, or behavioral outcomes of students in classrooms, it is essential to assess how responsive students are to teachers' attem...

Background There are no well‐established measures of group cohesion, defined as the collaborative bond between group members, in group cognitive behavioral therapy (GCBT) with youth. We therefore examined the Therapy Process Observational Coding System for Child Psychotherapy—Group Cohesion Scale (TPOCS‐GC), which has previously only been used with...

ARTICLE FREE TO ACCESS AT: https://doi.org/10.1080/15374416.2022.2158842. In this editorial statement, we briefly delineated a series of observations, guidelines, and directions for future research focused on the most common outcome of multi-informant assessments of youth mental health. Discrepancies commonly occur between estimates of youth mental...

Objective: The precise measurement of treatment fidelity (quantity and quality in the delivery of treatment strategies in an intervention) is essential for intervention development, evaluation, and implementation. Various informants are used in fidelity assessment (e.g., observers, practitioners [clinicians, teachers], clients), but these informan...

Background Providing high-quality early childhood care and education is widely understood as key to maximizing children's potential to succeed later in life, as it equips young children with the essential skills and competencies needed for their development. Despite the government's efforts to support the early childhood sector, educators in Singap...

Home–school partnerships between teachers and caregivers of students with or at risk of emotional/behavioral disorders (EBD) are critical to support positive student outcomes. Yet, effective home–school partnerships may be particularly challenging to foster for students with or at risk of EBD, and little is known about how teachers and caregivers v...

Objective Assessing treatment fidelity in effectiveness research is critical to interpreting study findings. This paper details the development and initial psychometric evaluation of the Modular Evidence-Based Practices for Youth with Autism Fidelity Scale (MEYA-FS) designed to support the assessment of cognitive-behavioral treatments for youth wit...

Despite ongoing reforms to child protection systems and calls for a greater focus on prevention and early intervention, demand on statutory services continues to grow across developed countries. The reasons for this are multiple and complex and include: (1) barriers that exist within service systems themselves; (2) the entrenched and interwoven nat...

Background The current gold standard for measuring fidelity (specifically, adherence) to cognitive behavioral therapy (CBT) is direct observation, a costly, resource-intensive practice that is not feasible for many community organizations to implement regularly. Recent research indicates that behavioral rehearsal (i.e., role-play between clinician...

Clinician fidelity to cognitive behavioral therapy (CBT) is an important mechanism by which desired clinical outcomes are achieved and is an indicator of care quality. Despite its importance, there are few fidelity measurement methods that are efficient and have demonstrated reliability and validity. Using a randomized trial design, we compared thr...

Evidence-based programs (EBPs) delivered in elementary schools show great promise in reducing risk for emotional and behavioral disorders (EBDs). However, efforts to sustain EBPs in school face barriers. Improving EBP sustainment thus represents a priority, but little research exists to inform the development of sustainment strategies. To address t...

Mental health organizations that serve youth are under pressure to adopt measurement-based care (MBC), defined as the continuous collection of client-report data used to support clinical decision-making as part of standard care. However, few frameworks exist to help leadership ascertain how to select an MBC approach for a clinical setting. This pap...

While the measurement of treatment integrity is important to determine how much, and how well, interventions are delivered in schools, the science of treatment integrity is not well developed in education research. The purpose of this paper is to describe a program of research that has developed treatment integrity measures over the past 10 years t...

Teacher-reported measures of treatment integrity (the extent to which prescribed practices are delivered as intended by teachers) have the potential to support efforts to evaluate and implement evidence-based interventions in early childhood settings. However, self-report treatment integrity measures have shown poor correspondence with observer-rep...

To examine treatment fidelity in a randomized controlled trial of indicated school-based cognitive-behavioral therapy (CBT) delivered in groups to youth with anxiety. We investigated whether adherence and competence (a) differed across brief and standard-length CBT, and (b) if adherence and competence predicted change in anxiety symptoms and impair...

The purpose of this special series is to highlight how the measurement of integrity, both treatment integrity and integrity for implementation strategies, can support intervention development, evaluation, and implementation research. The seven papers and one commentary in this special series illustrate how diverse measurement approaches are used fo...

An observational coding system was developed to track clinical change in children with autism spectrum disorder (ASD) during psychotherapy. The Pediatric Autism Spectrum Therapy Observation System (PASTOS) consists of 23 items divided into 5 subscales and is used to rate child behaviors in individual psychotherapy sessions. Manual-based cognitive b...

Though treatment integrity measurement is important for research intended to promote social and behavioral outcomes of children at risk for emotional and behavioral disorders (EBDs) in early childhood settings, measurement gaps exist in the field. This paper reports on the development and preliminary psychometric assessment of the treatment integri...

Objective The core elements of family therapy for adolescent mental health and substance use problems, originally distilled from high-fidelity sessions conducted by expert clinicians, were tested for validity generalization when delivered by community therapists in routine settings. Method The study sampled recorded sessions from 161 cases partici...

Background: Problem-solving (PS) has been identified as a common element in multiple evidence-based treatments for the prevention and treatment of depression. We undertook a systematic review of evidence for the effectiveness and implementation of PS for the prevention and treatment of depression among 13-25 year olds.Methods: We searched electroni...

Treatment adherence measurement can be time and resource-intensive in clinical trials, so the ability to measure protocol adherence for two distinct treatment programs with a single measure may benefit the field. The present study sought to determine if the Therapy Process Observational Coding System – Revised Strategies Scale (TPOCS-RS) could asse...

Measurement limitations lessen the conclusions about the role of the alliance in youth psychosocial treatment. This article examined the score reliability, factor structure, and validity of the 9-item Therapy Process Observational Coding System for Child Psychotherapy-Alliance scale (TPOCS-A). The sample, 51 youth aged 7-15 years (Mage = 10.36 year...

Although technical (quality of delivering techniques from a specific treatment) and global (general clinical expertise) competence are believed to be important ingredients of successful psychosocial treatment with youth, there have been few empirical efforts to measure both dimensions. Efforts to understand the role that each competence dimension p...

Mental health clinicians and administrators are increasingly asked to collect and report treatment outcome data despite numerous challenges to select and use instruments in routine practice. Measurement-based care (MBC) is an evidence-based practice for improving patient care. We propose that data collected from MBC processes with patients can be s...

Introduction: Studies have found that psychological treatments produce positive clinical outcomes for many problems experienced by youth. However, there is limited research on whether therapist adherence and competence in delivering these treatments are related to differential clinical outcomes. Method: We examined the relationship of therapist...

Background: Developing pragmatic assessment tools to measure clinician use of evidence-based practices is critical to advancing implementation of evidence-based practices in mental health. This case study details our community partnered process of developing the Therapy Process Observation Coding Scale-Self-Reported Therapist Intervention Fidelity...

Numerous evidence-based programs (EBPs) exist for delivery in schools to promote youth mental health outcomes. However, school systems often lack the internal infrastructure to support the effective implementation and sustainment of EBPs when external supports are withdrawn, resulting in notable attenuation in the benefits in youth clinical outcome...

Introduction: Studies have found that psychological treatments produce positive clinical outcomes for many problems experienced by youth. However, there is limited research on whether therapist adherence and competence in delivering these treatments are related to differential clinical outcomes. Method: We examined the relationship of therapist ad...

Cognitive behavioral therapy (CBT) is a psychosocial treatment with strong scientific evidence supporting its use with youth for a variety of emotional and behavioral problems. This chapter provides a broad overview of CBT with youth divided into three sections. In the first section, the behavioral and cognitive theories that underlie the CBT appro...

The purpose of this paper is to determine how youth with anxiety recruited for a school-based randomized controlled trial (RCT) compare demographically and clinically to clinically referred youth with anxiety who participated in an RCT conducted in community mental health clinics. Youth (N = 99) with anxiety aged 12–15 years were: (a) 37 youth (M a...

As research and policy shift toward the use of evidence-based programs in settings that serve youth with emotional and behavioral disorders, stakeholders (e.g., teachers, mental health clinicians) are increasingly seeking to identify, adopt, and implement evidence-based programs. However, stakeholders sometimes struggle to implement these programs...

Although the alliance is a consistent predictor of treatment outcomes in psychosocial intervention, few studies have examined this association among youth with autism spectrum disorder (ASD). In particular, youth-therapist alliance has never been examined in social skills interventions (SSI), a common modality for this population. In this study, th...

Observational measurement of treatment adherence has long been considered the gold standard. However, little is known about either the generalizability of the scores from extant observational instruments or the sampling needed. We conducted generalizability (G) and decision (D) studies on two samples of recordings from two randomized controlled tri...

Student problem behaviors in early elementary school are associated with fewer learning opportunities, poor relationships with teachers, and academic and behavioral problems, including increased risk of emotional/behavioral disorders (EBDs). This study examined the effect of BEST in CLASS–Elementary (BEST in CLASS-E), a Tier 2 intervention delivere...

The purpose of this paper is to determine how youth with anxiety recruited for a school-based randomized controlled trial (RCT) compare demographically and clinically to clinically referred youth with anxiety who participated in an RCT conducted in community mental health clinics. Youth (N = 99) with anxiety aged 12-15 years were: (a) 37 youth (M a...

Most efforts to assess treatment integrity—the degree to which a treatment is delivered as intended—have conflated content (i.e., therapeutic interventions) and delivery (i.e., strategies for conveying the content, such as modeling). However, there may be value in measuring content and delivery separately. This study examined whether the quantity (...

There is a growing emphasis on utilizing evidence-based treatments in community settings; yet little is known about treatment practices in usual care. The first aim of this study sought to describe treatment-as-usual (TAU) for children at risk of physical abuse, and identify elements of one evidence-based treatment, Alternatives for Families: A Cog...

Students' early school experiences have a significant and long-term effect on key academic and social/behavioral outcomes. Evidence-based programs that both increase the quantity and quality of positive teacher-student interactions and decrease the frequency of negative teacher-student interactions may be critical for changing negative patterns and...

Objectives This study investigated whether the supervisory alliance between professionals and supervisors contributes to strong client-professional alliances and positive outcomes of home-based parenting support provided by youth care organizations. Methods Multi-informant self-report supervisory alliance, alliance, and outcome data from 124 paren...

Family therapy has the strongest evidence base for treating adolescent conduct and substance use problems, yet there remain substantial barriers to widespread delivery of this approach in community settings. This study aimed to promote the feasibility of implementing family-based interventions in usual care by empirically distilling the core practi...

Background. Home-based parenting support within youth care services is one of the key interventions provided to families encountering difficulties with child rearing and child development. However, knowledge on factors contributing to positive outcomes of home-based parenting support is limited. Objective. The current study investigated the predi...

This comprehensive, 51-chapter handbook presents recent advances in the expression, etiology, assessment, and treatment of child and adolescent psychiatric disorders and related problems from a developmental psychopathology perspective. Following a broad conceptual overview of this area of clinical research and practice, assessment and treatment pr...

This study investigated if training and practice-based coaching in an evidence-based program was associated with higher observed treatment integrity (adherence and competence) and if these treatment integrity components were associated with teacher report of child behavioral outcomes in the BEST in CLASS efficacy trial. Participants were 462 childr...

To make evidence-based treatments deliverable, effective, and scalable in community settings, it is critical to develop a workforce that can deliver evidence-based treatments as designed with skill. However, the science and practice of clinician training and consultation lag behind other areas of implementation science. In this paper, we present th...

Improving social, emotional, and behavioral outcomes of students with and at-risk for emotional and behavioral disorders (EBD) remains a challenge for educators, and it has long been noted that teachers do not consistently use effective instructional practices with students with EBD. Identifying evidence-based practices that address the problems ex...

Objective: To evaluate the importance of therapeutic processes in two brief school-based psychosocial treatments targeting homework problems in adolescents with attention-deficit/hyperactivity disorder (ADHD) as delivered by school mental health professionals. Method: A sample of 222 middle school students (72% male; Mage = 12.00 years, SD = 1.02)...

A strong parent-professional alliance that increases over the course of care predicts positive outcomes of home-based parenting support. However, little is known about factors that influence the development or maintenance of the alliance in home-based parenting support, limiting professionals’ ability to optimize the parent-professional alliance an...

Alliance is defined as the client-therapist bond and their ability to collaborate on therapeutic activities. Treatment for adolescents with ADHD is rarely studied in terms of alliance. In this study, two cognitive-behavioral treatments (CBT; one structured treatment aimed at planning skills and one less-structured solution-focused treatment, both d...

Objective: We examined whether motivation and treatment credibility predicted alliance in a 10-session cognitive behavioral treatment delivered in community clinics for youth anxiety disorders. Method: Ninety-one clinic-referred youths (meanage = 11.4 years, standard deviation = 2.1, range 8-15 years, 49.5% boys) with anxiety disorders-rated tre...

Evidence-based treatments (EBTs) for youth are typically developed and established through studies in research settings designed to ensure treatment integrity, that is, protocol adherence and competence by therapists. An important question for implementation science is how well integrity is maintained when these EBTs are delivered in community sett...

Objective: We describe the development and initial psychometric properties of the observer-rated Global Therapist Competence Scale for Youth Psychosocial Treatment (G-COMP) in the context of cognitive-behavioral treatment (CBT) for youth anxiety disorders. Method: Independent coders rated 744 sessions from a sample of 68 youth (mean age = 10.56...

Teachers sometimes struggle to deliver evidence-based programs designed to prevent and ameliorate chronic problem behaviors of young children with integrity. Identifying factors associated with variations in the quantity and quality of delivery is thus an important goal for the field. This study investigated factors associated with teacher treatmen...

Common practice elements were identified from a comprehensive literature review of evidence-based programs and interventions targeting social, emotional, and behavioral outcomes of students with problem behavior in early elementary school classrooms.

This article describes several barriers to widespread dissemination of manualized family-based treatments for adolescent substance use (ASU). We then offer a highly promising solution for adopting and sustaining family therapy in usual care: distilling the core practice elements of empirically validated family therapy models for ASU. We present a c...

This review systematically explored research examining the relation between parent-professional alliance and outcomes of psychosocial treatments provided to children, and their parents and families. Study findings and methodological characteristics were reviewed to investigate the evidence linking the alliance between parents and professionals to o...

This study examined the score reliability and validity of observer- (Therapy Process Observational Coding System for Child Psychotherapy—Alliance scale [TPOCS-A]; Vanderbilt Therapeutic Alliance Scale Revised, Short Form [VTAS-R-SF]), therapist- (Therapeutic Alliance Scale for Children Therapist Version [TASC-T]), and youth-rated (Therapeutic Allia...

The advancement of implementation science is dependent on identifying assessment strategies that can address implementation and clinical outcome variables in ways that are valid, relevant to stakeholders, and scalable. This paper presents a measurement agenda for implementation science that integrates the previously disparate assessment traditions...

Therapist competence is an important component of treatment integrity. This article reports on the development and initial psychometric assessment of the Cognitive-Behavioral Treatment for Anxiety in Youth Competence Scale (CBAY-C), an observational instrument designed to capture therapist limited-domain competence (i.e., competence in the delivery...

Background: This randomized trial will compare three methods of assessing fidelity to cognitive-behavioral therapy (CBT) for youth to identify the most accurate and cost-effective method. The three methods include self-report (i.e., therapist completes a self-report measure on the CBT interventions used in session while circumventing some of the t...

This presentation is based on a systematic review on the association between the parent-professional alliance and outcomes of youth and family care. In child and family social services, parents play an important role (Accurso, Hawley, & Garland, 2013; Chaffin & Bard, 2011). They are either the main target of service delivery (e.g., parenting suppor...

Educators are increasingly being encouraged to implement evidence-based interventions and practices to address the social, emotional, and behavioral needs of young children who exhibit problem behavior in early childhood settings. Given the nature of social-emotional learning during the early childhood years and the lack of a common set of core evi...

Does delivery of the same manual-based individual cognitive-behavioral treatment (ICBT) program for youth anxiety differ across research and practice settings? We examined this question in a sample of eighty-nine youths (M age = 10.56, SD = 1.99; 63.70% Caucasian; 52.80% male) diagnosed with a primary anxiety disorder. The youths received (a) ICBT...

The present study assessed the potential of a health behavior model used to explain adherence to treatment for chronic illnesses, the Integrative Behavioral Prediction Model (IBPM), to better understand therapy engagement (e.g., low participation) for child therapy in community-based service settings. Qualitative interview methods were used to asse...

Objective: Does the strength of the youth-therapist alliance differ across treatment settings or treatment type? We examined these questions in the context of youth therapy. Method: Eighty-nine youths (M age = 10.56, SD = 1.99; 63.70% Caucasian; 52.80% male) diagnosed with an anxiety disorder received (a) manual-based individual cognitive-behavi...

Background: In individual cognitive behavioral therapy (ICBT) for youth anxiety disorders, it is unclear whether, and from whose perspective, the alliance predicts outcome. We examined whether youth- and therapist-rated alliance, including level of youth-therapist alliance agreement, predicted outcome in a randomized controlled trial. Methods: Y...

Over 10% of all children meet the criteria of anxiety disorders, making it one of the most pervasive psychiatric problems experienced by school-aged kids. Whether it takes the form of fear, worry, separation anxiety, social phobia, generalized anxiety, panic, obsessive-compulsive disorder, or PTSD, anxiety can be a severe impediment to a child's fa...

The measurement of treatment adherence (a component of treatment integrity defined as the extent to which a treatment is delivered as intended) is a critical element in treatment evaluation research. This article presents initial psychometric data for scores on the Cognitive-Behavioral Therapy Adherence Scale for Youth Anxiety (CBAY-A), an observat...

Observational measures to assess implementation integrity (the extent to which components of an evidence-based treatment are delivered as intended) are needed. The authors evaluated the reliability of the scores and the validity of the score interpretations for the Therapy Process Observational Coding System for Child Psychotherapy—Revised Strategi...

Evidence-based interventions for youth with autism spectrum disorders (ASD) are rarely found in community settings where most youth with ASD receive services. Implementation research designed to help bridge this gap is needed. However, efforts to implement evidence-based interventions in community settings face a number of barriers. The main purpos...

This special series is designed to highlight recent advances in the evidence-based treatment and assessment of youth with autism spectrum disorder (ASD). The seven articles for this special series include novel applications of cognitive-behavioral therapy to address core aspects of ASD, empirical research that provides understanding of ways to asse...

Although anxiety is frequently reported among children and adolescents with autism spectrum disorder (ASD), it has not been established that the manifest symptoms of anxiety in the context of ASD are the same as those seen in youth without ASD. This study sought to examine the metric and latent factor equivalence of anxiety as measured by the Multi...

Background: Despite growing study and treatment, questions remain about presentation, measurement and impact of anxiety in ASD. Do symptoms of anxiety in ASD resemble traditional anxiety disorder symptoms? Do they incur similar costs? Few studies have directly addressed these crucial issues, which underscore the importance of this research. Limitat...

Building a strong therapeutic relationship is an important part of evidence-based practice. The therapeutic relationship is believed to play an instrumental role in cognitive-behavioral therapy (CBT) for children with anxiety and depressive disorders by increasing child engagement in the skill-building and emotionally challenging tasks of CBT. In t...

Though case conceptualization is considered to be a component of evidence-based practice, the case conceptualization process is not always guided by scientific findings. Case conceptualization is a collaborative process of generating hypotheses about causes, antecedents, and maintaining influences for an individual client’s problems within a biopsy...

Young children with and at risk for emotional/behavioral disorders (EBD) present challenges for early childhood teachers. Evidence-based programs designed to address these young children's behavior problems exist, but there are a number of barriers to implementing these programs in early childhood settings. Advancing the science of treatment integr...

Little is known about the nature of the relationship between the alliance and client involvement in child psychotherapy. To address this gap, we examined the relationship between these therapy processes over the course of cognitive-behavioral therapy (CBT) for child anxiety disorders. The sample was 31 child participants (M age = 9.58 years, SD = 2...

The measurement of treatment integrity is critical to evaluate the efficacy and effectiveness of evidence-based programs (EBPs) designed to improve the developmental outcomes of young children at risk of emotional/behavioral disorders. Unfortunately, the science of treatment integrity measurement lags behind the development and evaluation of EBP fo...

Most randomized controlled trials of cognitive-behavioral therapy (CBT) for children with anxiety disorders have evaluated treatment efficacy using recruited samples treated in research settings. Clinical trials in school settings are needed to determine if CBT can be effective when delivered in real world settings. This study evaluated a modular C...

Introduction: The number of young children demonstrating problem behavior in early childhood settings that interferes with social/emotional development continues to rise, and many of these young children will not receive intervention services until approximately age 9, which is alarming as evidence shows early problem behavior is alterable with ear...

To continue to move the science of clinical psychology forward, this handbook brings together some of the field's foremost experts to explicate the essential research strategies currently used across the modern clinical psychology landscape that maximize both precision and significance. This volume addresses design, measurement, and analytic strate...

Measures of treatment integrity are needed to advance clinical research in general and are viewed as particularly relevant for dissemination and implementation research. Although some efforts to develop such measures are underway, a conceptual and methodological framework will help guide these efforts. The purpose of this article is to demonstrate...

This special series focuses upon the ways in which research on treatment integrity, a multidimensional construct including assessment of the content and quality of a psychosocial treatment delivered to a client as well as relational elements, can inform dissemination and implementation science. The five articles for this special series illustrate h...