John Weisz

Harvard University | Harvard · Department of Psychology

Objective: Research has identified racial/ethnic disparities in mental health treatment engagement, and there have been recent calls to examine effects of mental health treatment engagement on clinical outcomes among youth of color. This study aimed to examine racial/ethnic differences in (a) behavioral and attitudinal engagement, (b) treatment eff...

Background A randomized controlled trial was conducted to examine the effectiveness of the Modular Approach to Therapy for Youths with Anxiety, Depression, Trauma, and Conduct Problems (MATCH) for Norwegian youths referred to seven Child and Adolescent Psychiatric Outpatient Clinics. MATCH addresses comorbid problems that are common in children and...

Objective: Self-guided digital mental health interventions (DMHIs) teaching empirically supported skills (e.g. behavioral activation) have demonstrated efficacy for improving youth mental health, but we lack evidence for the complex skill of cognitive restructuring (CR). Method: We conducted the first-ever RCT testing a CR DMHI ("Project Think")...

Background Most evidence on suicidal thoughts, plans and attempts comes from Western countries; prevalence rates may differ in other parts of the world. Aims This study determined the prevalence of suicidal thoughts, plans and attempts in high school students in three different regional settings in Kenya. Method This was a cross-sectional study o...

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...

In order to provide more individualized support, it is imperative to further understand the effectiveness of different types of psychotherapy on the clinical areas of need common in autistic youth (Wood et al. in Behav Ther 46:83–95, 2015). Randomized controlled trials of psychotherapy for autistic youth were included if published in English, inclu...

Background Climate change has psychological impacts but most of the attention has been focused on the physical impact. This study was aimed at determining the association of climate change with adolescent mental health and suicidality as reported by Kenyan high school students. Methods This was a cross sectional study with a sample size of 2,652....

Objective: Research has identified racial/ethnic disparities in mental health treatment engagement. Yet, most existing effectiveness research overlooks the potential moderating effects of treatment attitudinal and behavioral engagement. The study addressed this gap and built on recent calls to examine effects of mental health treatment engagement o...

Background Hundreds of youth psychotherapy randomized trials have generated scores of helpful empirically supported treatments (ESTs). However, the standardized structure of many ESTs and their focus on a single disorder or homogeneous cluster of problems may not be ideal for clinically referred youths who have comorbidity and whose treatment needs...

Background: Hundreds of youth psychotherapy randomized trials have generated scores of helpful empirically supported treatments (ESTs). However, the standardized structure of many ESTs and their focus on a single disorder or homogeneous cluster of problems may not be ideal for clinically referred youths who have comorbidity and whose treatment need...

Investigating the mechanisms through which psychotherapy brings about desired change can inform efforts to improve therapies. We applied meta-analytic structural equation modeling (MASEM) to assess putative change mechanisms for cognitive behavioral therapy (CBT) as mediators of youth depression treatment outcome. Then, we tested whether candidate...

Background Low- and middle-income countries (LMICs) have the highest socio-economic burden of mental health disorders, yet the fewest resources for treatment. Recently, many intervention strategies, including the use of brief, scalable interventions, have emerged as ways of reducing the mental health treatment gap in LMICs. But how do decision make...

Adolescent internalizing problems (e.g., depression, anxiety) are common, but fewer than half of affected adolescents access treatment. This need-to-access gap may have been exacerbated during the coronavirus pandemic. To help address this challenge, we evaluated the potential mental health benefits of a digital single-session intervention using an...

Background: Mental health problems cause significant distress and impairment in adolescents worldwide. One-fifth of the world's adolescents live in India, and much remains to be known about their mental health and wellbeing. Aim: In this preregistered study, we aimed to estimate the rates of depressive and anxiety symptoms, examine their relatio...

Background Youth anxiety and depression have long been combined within the empirically derived internalizing syndrome. The two conditions show substantial comorbidity, symptom co‐occurrence, and overlap in treatment procedures, but paradoxically diverge in psychotherapy outcomes: strong, positive effects for anxiety and weak effects for depression....

Background: Low- and middle-income countries (LMICs) have the highest socio-economic burden of mental health disorders, yet the fewest resources for prevention. Recently, many intervention strategies — including the use of brief, scalable interventions— have emerged as ways of reducing the mental health treatment gap in LMICs. But how do decision m...

Modular youth psychotherapies are increasingly popular, in part because their flexibility facilitates personalizing, but the clinician decision-making required can be complex. We investigated decision guidance in 20 modular youth psychotherapies, described in 67 articles identified via a systematic search. Decision guidance was limited. Clinical ju...

Intervention scientists have published more than 600 randomized controlled trials (RCTs) of youth psychotherapies. Four decades of meta-analyses have been used to synthesize the RCT findings and identify scientifically and clinically significant patterns. These meta-analyses have limitations, noted herein, but they have advanced our understanding o...

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...

This study aimed at determining the prevalence of stress, different types of stress, their severity and their determinants in Kenyan university, college and high school students. The following tools were administered to 9741 students: (1) Researcher-designed socio-demographic tool, (2) Psychiatric Diagnostic Screening Questionnaire (PDSQ) for psych...

Researchers strategically assess youth mental health by soliciting reports from multiple informants. Typically, these informants (e.g., parents, teachers, youth themselves) vary in the social contexts where they observe youth. Decades of research reveal that the most common data conditions produced with this approach consist of discrepancies across...

Objective: Because most youth psychotherapies are developed and tested in high-income countries, relatively little is known about their effectiveness or moderators in low- and middle-income countries (LMICs). To address this gap, we conducted a meta-analysis of randomized controlled trials (RCTs) testing psychotherapies for youth with multiple psy...

Brief digital interventions (BDIs) may help address the mental health needs of students when realworld resource constraints limit access to in-person or longer-form care. This article describes BDIs, which are conceptualized as being at the intersection of short-term interventions, internet-delivered cognitive behavior therapy programs, and measure...

Objective Understanding the efficacy of each module of cognitive behavioral therapy (CBT) may inform efforts to improve outcomes for youth depression, but effects of specific modules have been difficult to examine. Idiographic interrupted time series models offer a robust way to estimate module effects on an individual’s symptoms. This study examin...

Intervention scientists have proposed a focus on empirically supported principles of change (ESPCs) in psychotherapies. We explored this proposition as applied to youth psychotherapies, focusing on five candidate ESPCs—calming, increasing motivation, changing unhelpful thoughts, solving problems, and practicing positive opposites. We synthesized 34...

In this article, we provide an overview of the current state of the literature on youth psychotherapy effectiveness, as well as how treatment effects have varied across time, targeted problems, and contexts. We also describe the development of transdiagnostic and modular psychotherapies for youths with multiple mental health problems, and we note c...

Objective Discrepancies among the key stakeholders in youth psychotherapy (e.g., caregivers, youths) commonly present an obstacle to treatment planning, forcing clinicians to align with one perspective over another and increasing the likelihood of a treatment plan that is not fully responsive to divergent opinions. At the same time, multi-stakehold...

Background: Research dedicated to youth mental health problems in low – resource countries is an urgent and critical global health priority. Prior to COVID-19, only a handful of studies had estimated the prevalence rates of youth depression and anxiety and identified the associations between these problems with socio-demographic and psychosocial va...

Brief and low intensity (LI) interventions are a relatively new approach to delivering evidence-based psychological treatments for adults presenting with common mental health problems, and an even newer approach for working with children and young people. Over recent years, empirically validated brief and LI psychological treatments for children an...

This study assessed the psychometric properties of standard Western-derived instruments, the prevalence of depression and anxiety symptoms, and their associations with sociodemographic and wellbeing variables in a large sample of Kenyan adolescents. Self-report measures of depression (PHQ-8) and anxiety (GAD-7) symptoms, social support, gratitude,...

Standardized assessment tools developed in western contexts may systematically miss certain problems that are considered important in non-western cultures. In this mixed-methods study, we used an open-ended assessment tool (the Top Problem Assessment; TPA) to identify culturally relevant concerns among low-income Kenyan youth. We then (a) applied t...

Youth depression is an impairing pediatric condition for which psychotherapy effects are modest. Can outcomes be improved by treatments that address the family context, as proposed in practice parameters of the American Academy of Child and Adolescent Psychiatry? To find out, we searched five decades of research for randomized controlled trials tes...

Background Adolescents in low- and middle-income countries in need of mental health care often do not receive it due to stigma, cost, and lack of mental health professionals. Culturally appropriate, brief, and low-cost interventions delivered by lay-providers can help overcome these barriers and appear effective at reducing symptoms of depression a...

Asian American (AsA) youth comprise a large and fast-growing proportion of the U. S. population. AsA youth have comparable and sometimes higher rates of mental health concerns compared to White youth, but are significantly less likely to access mental health services. Cognitive-behavioral therapy (CBT) was originally designed by and for White and W...

Background The earlier younger people begin to use drugs, the more vulnerable they become to both their short term and long-term harmful effects. The overall aim of this study is to determine the prevalence of alcohol and drug abuse, the socio-demographic characteristic, perception of abuse and associated economic indicators and mental disorders an...

In cross-cultural psychological treatment research, investigators must ensure that protocols for addressing risk are culturally tailored and feasible, while also protecting against harm. Guidelines including the Belmont Report1 and the Declaration of Helsinki2 emphasize respecting participants' autonomy and right to equitable treatment, minimizing...

Irritability is often described as a common problem affecting youth referred for mental health services; however, little is known about the prevalence and nature of irritability as a focus of treatment. We examined assessment data from a diverse sample of youths (N = 206; ages 7–15; 52% male, 48% female; 33% White, 27% Black, 25% Latinx) referred f...

Objective Expanding mental healthcare for adolescents in low-income regions is a global health priority. Group interventions delivered by lay-providers may expand treatment options. Brief, positively-focused interventions conveying core concepts of adaptive functioning may help reduce adolescent symptoms of mental illness. In this trial, we tested...

Social Anxiety Disorder is highly prevalent among children and leads to poor long-term outcomes if left untreated. Theoretical models of anxiety differ in whether children with Social Anxiety Disorder experience objective social skills deficits, negative self-interpretation biases, or some combination of the two. This pilot study evaluated evidence...

Background About a third of youth with suicidal ideation develop suicidal plans and about 60% of youth with suicidal plans make suicidal attempts. This study aimed to study different types of suicidal ideation and the risk factors in Kenyan youth. Methods We studied a total of 9742 high school, college and university students using following self-...

Our understanding of child, adolescent, and caregiver mental health (MH) problems during the coronavirus pandemic, and which interventions are needed, may be advanced by consumer input. 133 general population caregivers reported top MH problems and needs for themselves and their children (Mage=8.21; SD=4.94), using standardized and idiographic meas...

Background Treatments for youth mental disorders are a public health priority, especially in sub-Saharan Africa (SSA), where treatment options remain limited due to high cost, elevated stigma, and lack of trained mental health professionals. Brief, accessible, and non-stigmatizing community-based interventions delivered by lay providers may help ad...

Reports on remote psychotherapies for youth (e.g., technology-based treatment) suggest it is acceptable, feasible, and useful in overcoming logistical barriers to treatment. But how effective is remote care? To find out, PsycINFO and PubMed were searched from 1960 through 2020, supplemented by journal searches and reference trails, to identify rand...

Objective: Cognitive Behavioral Therapy (CBT) was dismantled into four modules of three sessions each: cognitive restructuring (Think), behavioral activation (Act), problem solving (Solve) and relaxation (Relax). We investigated the modules' relative effectiveness in indicated depression prevention for adolescents and examined variations in sequen...

Meta-analyses show that psychotherapies are effective in the treatment of depression in children and adolescents. However, these effects are usually reported in terms of effect sizes. For patients and clinicians, it is important to know whether patients achieve a clinically significant improvement or deterioration. We conducted such a meta-analysis...

Background Available evidence on the comparative efficacy and acceptability of psychotherapies for post-traumatic stress disorder (PTSD) in children and adolescents remains uncertain. Objective We aimed to compare and rank the different types and formats of psychotherapies for PTSD in children and adolescents. Methods We searched eight databases...

Background : Network analyses have been applied to understand the relationships between individual symptoms of depression and anxiety. However, little is known about which symptoms are most strongly associated with “positive” indicators of mental health, such as happiness. Furthermore, few studies have examined symptom networks in participants from...

We examined whether cultural sexism (county- and state-level sexist attitudes) moderates the efficacy of psychotherapies by re-analyzing data from a previous meta-analysis of randomized controlled trials of youth psychotherapy for the most commonly targeted problems (depression, anxiety, conduct, attention-deficit hyperactivity disorder; 2,698 effe...

Few measures of autism-related symptoms have been established as both psychometrically robust and sensitive to the effects of treatment. In the present study, a personalized measure of autism-related symptoms using the Youth Top Problems (YTP) method (Weisz et al., 2011) was evaluated. Participants included 68 children with diagnoses of autism (age...

Objective Discrepancies between caregiver and youth reports of emotional and behavioral symptoms are well-documented, with cross-informant correlations often falling in the low to moderate range. Studies have shown that caregiver-youth (dis)agreement in reporting of youth symptoms is related to treatment outcomes. However, commonly used methods for...

We examined whether cultural sexism (county- and state-level gender attitudes) moderates the efficacy of psychotherapies by re-analyzing data from a previous meta-analysis of randomized controlled trials of youth psychotherapy for the most commonly targeted problems (depression, anxiety, conduct, attention-deficit hyperactivity disorder; 2,698 effe...

Objective We examined whether anti-Black cultural racism moderates the efficacy of psychotherapy interventions among youth. Method We analyzed a subset of studies from a previous meta-analysis of five decades of youth psychotherapy randomized controlled trials. Studies were published in English between 1963 and 2017 and identified through a system...

Objective: To evaluate the costs and cost-effectiveness of Shamiri-Digital, an online single-session intervention (SSI) for depression among Kenyan adolescents. Method: Data were drawn from a randomized clinical trial with n = 103 Kenyan high school students (64% female, Mage = 15.5). All students were eligible to participate, regardless of baselin...

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...

Background Treatment of a child who has an anxiety disorder usually begins with the question of which treatment to start first, medication or psychotherapy. Both have strong empirical support, but few studies have compared their effectiveness head-to-head, and none has investigated what to do if the treatment tried first isn’t working well—whether...

Importance Low-cost interventions for adolescent depression and anxiety are needed in low-resource countries such as those in Sub-Saharan Africa. Objective To assess whether Shamiri, a 4-week layperson-delivered group intervention that teaches growth mindset, gratitude, and value affirmation, can alleviate depression and anxiety symptoms in sympto...

Background Mental health problems are the leading cause of disability among adolescents worldwide, yet access to treatment is limited. Brief digital interventions have been shown to improve youth mental health, but little is known about which digital interventions are most effective. Aims To evaluate the effectiveness of two digital single-session...

Objective: Loneliness is associated with negative mental health outcomes and is particularly common among adolescents. Yet, little is known about the dynamics of adolescent loneliness in non-Western, low-income nations. Accordingly, we estimated the severity of loneliness in a sample of Kenyan adolescents and used mixed-effects regression modelling...

Background: Treatments for youth mental disorders are a public health priority, especially in sub-Saharan Africa (SSA), where treatment options remain limited due to high cost, elevated stigma, and lack of trained mental health professionals. Brief, accessible, and non-stigmatizing community-based interventions delivered by lay-providers may help a...

Exposure to childhood adversity is a powerful risk factor for psychopathology. Despite extensive efforts, we have not yet identified effective or scalable interventions that prevent the emergence of mental health problems in children who have experienced adversity. In this modified Delphi study, we identified intervention strategies for effectively...

Objective Training lay providers to deliver mental health interventions is both effective and cost-effective. However, more research is needed to document training and supervision procedures and to collect lay providers’ feedback. Methods: This study documents training and supervision from a randomized controlled trial of the Shamiri intervention,...

Improving interventions for externalizing problems in adolescence may require determining which treatment elements actually produce change. In this micro-trial, we tested a treatment element addressing one widely-hypothesized mechanism underlying externalizing problems: emotion regulation. We tested whether emotion regulation could be improved via...

Background: Severe irritability is a common, impairing problem among youth referred for mental health services, but evidence to guide care is limited. Treatment research can be advanced by adopting a transdiagnostic perspective, leveraging existing evidence-based treatment (EBT) techniques, and situating irritability within the context of emotion d...

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...

Asian American (AsA) youth comprise a large and fast-growing proportion of the U. S. population. AsA youth have comparable, and in some cases higher, rates of mental health concerns compared to White youth, but are significantly less likely to utilize mental health services. Cognitive-behavioral therapy (CBT), although originally designed by and fo...

Some clinical scientists are shifting from research on complete named therapy protocols to a more elemental approach—research on specific therapy components that contribute to therapy goals. To characterize and evaluate this emerging field, we systematically searched PsycINFO and Medline for studies evaluating therapy components. We identified 208...

More than 50 years of randomized clinical trials for youth psychotherapies have resulted in moderate effect sizes for treatments targeting the most common mental health problems in children and adolescents (i.e., anxiety, depression, conduct problems, and attention disorders). Despite having psychotherapies that are effective for many children, the...

Mental health disorders are prevalent among youth and adolescents in low- and middle-income countries, and access to evidence-based treatments is poor. Although there is a great need for high-quality research to serve young people in low- and middle-income countries, there is limited guidance available for researchers who wish to conduct such work....

Introduction: Schools have become a primary setting for providing mental health care to youths in the U.S. School-based interventions have proliferated, but their effects on mental health and academic outcomes remain understudied. In this study we will implement and evaluate the effects of a flexible multidiagnostic treatment called Modular Approac...

Background: Individual symptoms of mood disorders have been shown to have unique associations with other symptoms. However, little is known about which symptoms are most strongly associated with a) other internalizing symptoms and b) “positive” indicators of mental health, such as happiness. Methods: To better understand these relationships, we app...

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...