ArticlePublisher preview available

Evidence‐Based Treatments for Children and Adolescents: An Updated Review of Indicators of Efficacy and Effectiveness

Authors:
To read the full-text of this research, you can request a copy directly from the authors.

Abstract

[Clin Psychol Sci Prac 18: 154–172, 2011]This updated review of evidence-based treatments follows the original review performed by the Hawaii Task Force. Over 750 treatment protocols from 435 studies were coded and rated on a 5-level strength of evidence system. Results showed large numbers of evidence-based treatments applicable to anxiety, attention, autism, depression, disruptive behavior, eating problems, substance use, and traumatic stress. Treatments were reviewed in terms of diversity of client characteristics, treatment settings and formats, therapist characteristics, and other variables potentially related to feasibility and generalizability. Overall, the literature has expanded considerably since the previous review, yielding a growing list of options and information available to guide decisions about treatment selection.
Evidence-Based Treatments for Children and Adolescents:
An Updated Review of Indicators of Efficacy and
Effectiveness
Bruce F. Chorpita, University of California, Los Angeles
Eric L. Daleiden, PracticeWise, LLC
Chad Ebesutani, University of California, Los Angeles
John Young, University of Mississippi
Kimberly D. Becker, Johns Hopkins Bloomberg School of Public Health
Brad J. Nakamura, University of Hawaii
Lisa Phillips, PracticeWise, LLC
Alyssa Ward, University of California, Los Angeles
Roxanna Lynch, University of Hawaii
Lindsay Trent, University of Mississippi
Rita L. Smith, University of California, San Francisco
Kelsie Okamura, University of Hawaii
Nicole Starace, University of California, Los Angeles
This updated review of evidence-based treatments fol-
lows the original review performed by the Hawaii Task
Force. Over 750 treatment protocols from 435 studies
were coded and rated on a 5-level strength of evidence
system. Results showed large numbers of evidence-
based treatments applicable to anxiety, attention, aut-
ism, depression, disruptive behavior, eating problems,
substance use, and traumatic stress. Treatments were
reviewed in terms of diversity of client characteristics,
treatment settings and formats, therapist characteris-
tics, and other variables potentially related to feasibility
and generalizability. Overall, the literature has
expanded considerably since the previous review, yield-
ing a growing list of options and information available
to guide decisions about treatment selection.
Key words:
children, dissemination, evidence-based,
services.
[Clin Psychol Sci Prac 18: 154–172, 2011]
Numerous reviews of the child and adolescent treatment
literatures have been conducted over the past 30 years
(Lonigan, Elbert, & Bennett-Johnson, 1998; Silverman
& Hinshaw, 2008; Weisz, Hawley, & Jensen-Doss,
2004; Weisz, Weiss, Han, Granger, & Morton, 1995).
Our last comprehensive report (Chorpita et al., 2002)
preceded several advances, both in the scope and
methods of review and in the children’s mental health
literature. The mental health field in general continues
its focus on evidence-based practice, although there has
been continued controversy over definitions (e.g., APA
Presidential Task Force on Evidence-Based Practice,
Address correspondence to Bruce F. Chorpita, Department of
Psychology, University of California, Los Angeles, Box
951563, Los Angeles, CA 90095-1563. E-mail: chorpita@
ucla.edu.
2011 American Psychological Association. Published by Wiley Periodicals, Inc., on behalf of the American Psychological Association.
All rights reserved. For permissions, please email: permissionsuk@wiley.com 154
This document is copyrighted by the American Psychological Association or one of its allied publishers.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
... In contrast, others report that CBT focuses specifically on behavior change with younger children and less on selfregulatory processes (Minde et al., 2010). Chorpita et al. (2011) reported that the most efficacious intervention methods include CBT. However, Warwick et al. (2016) conclude that not all children respond to CBT, and additional children who experience relief with CBT are not maintained over time. ...
... Evidence-based methodology to address anxiety includes cognitive behavioral approaches as well as skill-based psychoeducation methods. Chorpita et al. (2011) reported that the most efficacious methods include CBT, exposure, modeling, education, CBT plus education, and CBT plus medication. Less effective methods included CBT with parents, relaxation, assertiveness training, CBT for children and parents, family psychoeducation, and hypnosis. ...
Article
Full-text available
This study explored the use of Brainspotting (BSP) in combination with Sand Therapy (ST) for use with 8–to 9-year-old children with anxiety symptoms in a school-based setting. Using the Spence Children's Anxiety Scales (SCAS), The Behavior and Feelings Survey (BFS), and the Top Problems Assessment (TPA), the research project measured anxiety as reported by parents/caregivers and students, internalizing, externalizing, and total concerns as reported by parents/caregivers, teachers, and students, and finally individually identified unique concerns as reported by parents/caregivers, teachers, and students. The researcher collected data from student participants (11) who experienced six sessions of BSP and ST. The quantitative data collected identified project signifiers for future researchers. Outcomes reflected statistical significance of a reduction in anxiety scores for parents in the subscale of generalized anxiety and a significant reduction of scores in children in the subscales of generalized anxiety and separation anxiety. Parents and teachers indicated significantly lower scores in internalizing and total concerns identified across time intervals. All three groups of reporters indicated a significant reduction of top problems identified across time intervals. Outcomes demonstrate the promise of the integrated practice of BSP and ST while laying a framework for future research of this method.
... Future studies should explore the effectiveness of this program for Mandarin-speaking children with DLD, but first, it is necessary to establish the importance of continually evaluating its intermediate-and long-term efficacy. Chorpita et al [73] have argued that, even if >10 successful replications support a particular treatment, this information would not be sufficient to determine whether this treatment is more suitable for a particular child than a treatment supported by only 2 instances of replication assuming the absence of predictors of differences in outcomes. This assumption underscores the importance of conducting effectiveness studies to determine whether intervention programs can be widely implemented in clinical settings. ...
Article
Background Children with developmental language disorder (DLD) often experience language difficulties that hinder their ability to acquire emotional competence. Poor emotional competence is associated with emotional and behavioral problems in young children. Objective This research involved two studies focusing on (1) the emotional competence of Mandarin-speaking children aged 5 to 7 years with DLD and (2) the efficacy, feasibility, and acceptability of a tele-intervention designed to enhance their emotional competence in Taiwan. Methods Five children with DLD from study 1 declined to participate in study 2, the emotional competence tele-intervention, and were excluded from the analysis. We compared the emotional competence of 20 Mandarin-speaking children with DLD to that of 24 children with typical language development (TLD). The children with DLD were, on average, aged 5.79 (SD 0.47) years, whereas the children with TLD were, on average, aged 5.93 (SD 0.31) years. We assessed the children’s emotional competence, nonverbal ability, verbal comprehension, vocabulary acquisition, and expressive language skills. In study 2, all children with DLD included in study 1 engaged in an emotional competence tele-intervention. An interrupted time-series design was used to examine their emotional competence. In total, 20 children with DLD provided data on emotional competence evaluated using the Emotional Lexicon Test. These data were individually collected at 3 time points after study 1 (time 1). These phases included baseline (time 1 to time 2), during the tele-intervention (time 2 to time 3), and follow-up (time 3 to time 4), spanning approximately 18 to 20 weeks from time 1 to time 4. Recruitment, retention, and attendance rates were calculated to evaluate the intervention’s feasibility, and participant mood was evaluated after each session to calculate the intervention’s acceptability. Results No significant changes in the children’s ability to understand basic or complex emotional terms were observed during the baseline period. However, changes were observed during the tele-intervention period, and these changes remained throughout the follow-up period. With a recruitment rate of 80% (20/25), all participants completed 4 intervention sessions, with retention and attendance rates exceeding 95% (19/20). A total of 90% (18/20) of the participants deemed each session to be acceptable. Conclusions Mandarin-speaking children aged 5 to 7 years with DLD exhibited lower emotional competence compared with their counterparts with TLD. Tele-interventions are effective in enhancing the emotional competence of children with DLD, demonstrating feasibility and acceptability for these children and their parents in Taiwan.
... Intensive behavioural and communication therapies are two interventions used in ASD for ameliorating the core symptoms [28]. The anxiety symptoms do not participate in the core symptoms of ASD, but they co-occur. ...
Article
Full-text available
Diagnostic and Statistical Manual of Mental Disorders (DSM)-5, with its revised criteria for diagnosis, highlights the dynamics between the presence of other conditions and the severity of symptoms in Autism Spectrum Disorder (ASD), along with atypical cognitive profiles. This theoretical review intends to explore various facets of adopting Cognitive Behavioural Therapy (CBT) for anxiety in ASD, exploring the existing literature. Recent trends are inching toward exploring efficacious interventions, including CBT for anxiety in ASD. Clinical trials point towards favourable outcomes of CBT for anxiety in ASD Level 1. Engaging adaptations and customizations to CBT well within the conceptual confines to compensate for the gaps and framing ASD-specific outcome measures are crucial to addressing the symptom diversity in ASD.
... Despite years of research on their development and testing, empirically supported methods of assessment and treatment are not reaching enough of the youth seen in child and adolescent mental health services (CAMHS) across countries [1][2][3]. Consequently, governments, policymakers and healthcare providers have re-prioritized their efforts to disseminate, and improve the uptake of, empirically supported methods in CAMHS [4,5]. Such efforts can be seen as part of a larger effort across child and adult mental health to improve clinical outcomes at the local level by helping clinicians to improve their decision making and practice by integrating the latest scientific findings, often summarized in national or local care guidelines, with the needs and values of their patients; referred to as Evidence-Based Practice (EBP) [6]. ...
Article
Full-text available
Background Implementation of evidence-based practice (EBP) in child and adolescent mental health services (CAMHS) is a priority to improve service delivery and outcomes. Clinicians’ EBP attitudes are likely to play a crucial role in implementation but are poorly understood. This study aimed to assess variation in EBP attitudes in a large national sample of CAMHS clinicians in Sweden, and to compare these findings to findings from the United States of America (USA). Methods CAMHS clinicians (n = 799; 60% response rate) completed the Evidence-Based Practice Attitude Scale (EBPAS) and items from the Organizational Readiness for Change Scale (ORC) ahead of an EBP for depression implementation effort across Sweden. EBPAS scores were compared with the USA study. Predictors of global and specific attitudes (gender, age, working years, education, profession, perceived benefit of diagnosis and organizational readiness and type of service) were examined using simple and multiple linear regressions. Results Clinicians had positive attitudes towards EBP on the four-dimensional subscales of the EBPAS, somewhat more so than their American counterparts. Clinician and organizational characteristics were related to at least one attitudinal dimension in both models, with perceived utility of diagnosis being the strongest and most consistent predictor across dimensions and models. Conclusions Results from this large-scale national study underscore the need to consider cultural, contextual, and individual variations in attitudes towards EBP when planning implementation efforts. Such efforts may need to be tailored to the working contexts, needs, and values of CAMHS clinicians, particularly their views on the utility of diagnosis.
... While literature extensively discusses work peculiarities in upbringing, education, and psychotherapy (McAleavey et al., 2019;Yang & Hayes, 2020), little is known about sociotherapy's work and workload. It is worth noting that sociotherapy as a form of assistance is not advanced in the process of professionalization, lacking structured promotion procedures and evidence-based practices to date (Chorpita et al., 2011;Youngstrom et al., 2017). Conducting research in this field is essential for developing good professional practices, and the research in this area is scarce to date . ...
Article
Full-text available
Sociotherapy is a widely used form of psychological and pedagogical group help for children and adolescents in Poland. However, it is still unknown under this name, which causes its marginalization in scientific research. Knowing that sociotherapists face myriad challenges in working with individuals, groups, and systemic challenges, we decided to examine the coping strategies that led them to successful outcomes while working with adolescents. We conducted in-depth interviews with 22 sociotherapists (aged 28–60), asking them to share narratives of difficulties they overcame at work. We analyzed the resulting statements about the subjects’ experience using reflective thematic analysis. We created the following themes, which reflect the structure of resources (themes), mobilized by the sociotherapists: (1) “I can rely on other professionals”; (2) “I am ready to work on and with myself”; (3) “I am ready to be a container for their feelings”; (4) “I need to take action!”; 5) “But I’m a sociotherapist, and I have a mission!”. Findings show that coping with challenges involves seeking support from professionals and acknowledging personal growth in the work environment. Supervision and crisis intervention policies may become vital resources for sociotherapists. Broader access to societies can strengthen their professional role and foster a community-supported principle of good practice in sociotherapy.
Article
Full-text available
Objective: Despite decades of policy emphasizing the role of evidence in guiding services, few studies have sought to improve the degree to which evidence is used in supervision and treatment. This study reports supervisor and therapist outcomes from the Reaching Families multisite cluster-randomized controlled trial, which tested the effects of a coordinated knowledge system (CKS) against practice guidelines (PG) on the use of evidence in supervision and treatment targeting low treatment engagement in publicly funded youth community mental health organizations located in two geographically distinct, underresourced communities where service inequities are common. Method: The sample included 121 mental health professionals (92.6% female; 81.0% Black, Indigenous, and people of color1) randomly assigned to a CKS or PG control condition. We recorded, transcribed, and coded 430 supervision and 208 treatment sessions involving 221 youth (Mage = 13.1 years, 46.2% female; 78.7% Black, Indigenous, and people of color) and/or their caregivers who reported engagement concerns during therapy. Results: CKS dyads showed uniformly greater use of evidence focused on specific client needs relative to dyads in the PG condition, with large effect sizes and no differences in the effect of condition across the sites. Secondary analyses showed that tools in the CKS condition were perceived significantly more positively than those in the PG condition in terms of effort and effectiveness, and supervisory workload was the same across both conditions. Conclusions: In routine clinical care delivered within highly representative community settings, a strategically designed knowledge resource can improve evidence-based reasoning and action and be perceived as easy to use and useful without negatively impacting workload. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
Book
Full-text available
Change processes in psychotherapy
Article
Background Caregiver-involved treatments for adolescents with alcohol use disorder and co-occurring disorders (AUD+CODs) are associated with the best treatment outcomes. Understanding what caregiving practices during treatment improve core adolescent treatment targets may facilitate the refinement and scalability of caregiver-involved interventions. Caregiving is dynamic, varying by context, affect, and adolescent behavior. Caregiver-involved treatments seek to change momentary interactions between caregivers and their adolescents. Accordingly, this protocol outlines a dyadic ecological momentary assessment (EMA) study to examine caregiving practices during AUD+CODs treatment and their associations with adolescent core treatment targets (eg, alcohol craving and use, motivation to reduce or stop drinking, and internalizing and externalizing symptoms). Objective This paper aims to describe the methods for examining momentary caregiving practices and adolescent core treatment targets during adolescent outpatient AUD+CODs treatment. Methods We will recruit 75 caregiver-adolescent dyads from outpatient mental health clinics providing AUD+CODs treatment. Eligible families will have an adolescent who (1) is aged between 13 and 18 years; (2) meets the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, diagnostic criteria for AUD; (3) is enrolled in outpatient treatment at the time of recruitment; and (4) has a legal guardian willing to participate in the study. Caregivers and adolescents will complete an eligibility screening, followed by a baseline assessment during or as close as possible to the second week of treatment. During the baseline assessment, caregivers and adolescents will receive formal training in EMA procedures. Next, caregivers and adolescents will complete a 15-week EMA burst design consisting of three 21-day EMA periods with 3-week breaks between periods. Throughout the study, participants will also complete weekly reports regarding the skills learned or practiced during therapy. The three overarching aims to the proposed study are as follows: (1) examine momentary caregiving practices (eg, support, monitoring, substance use communication quality) and their associations with core treatment targets, (2) examine how these associations change throughout treatment, and (3) examine whether a caregiver report of learning or practicing parenting- or family-focused behaviors in treatment sessions is associated with changes in the use of caregiving practices in daily life. Results The proposed study was informed by a pilot study assessing the feasibility and acceptability of dyadic EMA during adolescent AUD+COD treatment. Some benchmarks were met during this study (eg, ≥80% caregiver retention rate), although most benchmarks were not (eg, adolescent [772/1622, 47.6%] and caregiver [1331/1881, 70.76%] random prompt compliance was below the ≥80% target). Data collection is anticipated to begin in December of 2024. The proposed study is designed to be completed over 3 years. Conclusions Examining momentary caregiving practices using EMA has important implications for refining and scaling caregiver-involved interventions for AUD+CODs so that families who would benefit from caregiver-involved treatments can have access to them. International Registered Report Identifier (IRRID) PRR1-10.2196/63399
Article
Full-text available
A meta-analysis of child and adolescent psychotherapy outcome research tested previous findings using a new sample of 150 outcome studies and weighted least squares methods. The overall mean effect of therapy was positive and highly significant. Effects were more positive for behavioral than for nonbehavioral treatments, and samples of adolescent girls showed better outcomes than other Age × Gender groups. Paraprofessionals produced larger overall treatment effects than professional therapists or students, but professionals produced larger effects than paraprofessionals in treating overcontrolled problems (e.g., anxiety and depression). Results supported the specificity of treatment effects: Outcomes were stronger for the particular problems targeted in treatment than for problems not targeted. The findings shed new light on previous results and raise significant issues for future study.
Article
Full-text available
Evidence-based psychological treatments (EBTs) have made enormous gains in the range of techniques that are available and the scope of problems to which they can be applied. Debates about the advances focus on issues related to applicability of the evidence to clinical work, limits of highly controlled studies, and decision making in clinical practice. Less often discussed is arguably the more salient issue, namely, that most people in need of psychological treatment do not receive services, whether evidence based or not. This article discusses EBTs as currently studied in relation to an overarching goal of our interventions, namely, to reduce the burden of mental illness and the full range of social, emotional, and behavioral problems leading to impairment. The diversity of clients, the range of settings in which treatments must be delivered, and the models of delivery ought to receive greater attention in developing evidence-based interventions. In the context of treatment of children and adolescents, this article discusses service needs and how EBTs can better align with these needs to exert broad impact. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Full-text available
Responds to comments made by Holden and Blau (see record 2006-11202-017) on the current authors' original article (see record 2005-11115-005). The current authors suggest combining the complementary strengths of the community-based approaches identified by Holden and Blau (2006) and the evidence-based approaches discussed in their original article, rather than argue about the comparative limitations of each approach. Given that the contents of both systems of care and wraparound are free to vary with available services in the community, they suggest ensuring that those specific services are, in fact, interventions that have been tested and shown to work. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Like its three predecessors, the fourth edition of this book present current, informed reviews of research on treatments that work for a wide range of mental disorders. The 28 chapters cover pharmacological, psychosocial, and combined treatments for attention-deficit/hyperactivity disorder (ADHD), conduct disorder, disruptive behavior disorders, schizophrenic spectrum disorders, bipolar disorder in adults and children, major depressive disorder in adults and children, panic disorders, phobias, social and generalized anxiety disorders, obsessive-compulsive disorder, posttraumatic stress disorder (PTSD), eating disorders, sleep disorders, sexual dysfunctions, substance use disorders, gambling disorder, impulse control disorders, neurocognitive disorders, and personality disorders. Authors of most of the chapters were substantially involved in the development of the treatments reviewed in their chapters.
Article
The phrase primum non nocere ("first, do no harm") is a well-accepted credo of the medical and mental health professions. Although emerging data indicate that several psychological treatments may produce harm in significant numbers of individuals, psychologists have until recently paid little attention to the problem of hazardous treatments. I critically evaluate and update earlier conclusions regarding deterioration effects in psychotherapy, outline methodological obstacles standing in the way of identifying potentially harmful therapies (PHTs), provide a provisional list of PHTs, discuss the implications of PHTs for clinical science and practice, and delineate fruitful areas for further research on PHTs. A heightened emphasis on PHTs should narrow the scientist-practitioner gap and safeguard mental health consumers against harm. Moreover, the literature on PHTs may provide insight into underlying mechanisms of change that cut across many domains of psychotherapy. The field of psychology should prioritize its efforts toward identifying PHTs and place greater emphasis on potentially dangerous than on empirically supported therapies. © 2007 Association for Psychological Science.
Article
The evidence-based practice movement has become an important feature of health care systems and health care policy. Within this context, the APA 2005 Presidential Task Force on Evidence-Based Practice defines and discusses evidence-based practice in psychology (EBPP). In an integration of science and practice, the Task Force's report describes psychology's fundamental commitment to sophisticated EBPP and takes into account the full range of evidence psychologists and policymakers must consider. Research, clinical expertise, and patient characteristics are all supported as relevant to good outcomes. EBPP promotes effective psychological practice and enhances public health by applying empirically supported principles of psychological assessment, case formulation, therapeutic relationship, and intervention. The report provides a rationale for and expanded discussion of the EBPP policy statement that was developed by the Task Force and adopted as association policy by the APA Council of Representatives in August 2005
Article
The evidence-based practice movement has become an important feature of health care systems and health care policy. Within this context, the APA 2005 Presidential Task Force on Evidence-Based Practice defines and discusses evidence-based practice in psychology (EBPP). In an in- tegration of science and practice, the Task Force's report describes psychology's fundamental commitment to sophis- ticated EBPP and takes into account the full range of evidence psychologists and policymakers must consider. Research, clinical expertise, and patient characteristics are all supported as relevant to good outcomes. EBPP pro- motes effective psychological practice and enhances public health by applying empirically supported principles of psy- chological assessment, case formulation, therapeutic rela- tionship, and intervention. The report provides a rationale for and expanded discussion of the EBPP policy statement that was developed by the Task Force and adopted as association policy by the APA Council of Representatives in August 2005.
Article
There is confusion and misunderstanding about the concepts of knowledge translation, knowledge transfer, knowledge exchange, research utilization, implementation, diffusion, and dissemination. We review the terms and definitions used to describe the concept of moving knowledge into action. We also offer a conceptual framework for thinking about the process and integrate the roles of knowledge creation and knowledge application. The implications of knowledge translation for continuing education in the health professions include the need to base continuing education on the best available knowledge, the use of educational and other transfer strategies that are known to be effective, and the value of learning about planned-action theories to be better able to understand and influence change in practice settings.
Article
Four key areas of research work are identified: efficacy, effectiveness, practice, and service system. These research areas are placed within the paradigms of evidence-based practice and practice-based evidence. This article provides an introduction to these two paradigms and these four research areas together with examples of current work. From this basis, we argue for a knowledge base for the psychological therapies in which each area has a place within an overall research model and in which the interdependence of each area on the others is acknowledged. A cyclical model exemplifying the complementary relationship between evidence-based practice and practice-based evidence is presented as a means for furthering the delivery of a rigorous but relevant knowledge base for the psychological therapies. Copyright © 2003 John Wiley & Sons, Ltd.