Empirical and clinical focus of child and adolescent psychotherapy research.

The present study evaluated the characteristics of research on child and adolescent psychotherapy. Published studies (N?=?223) of psychotherapy from 1970 to 1988 were codified to characterize research, clinical, and methodological characteristics. The major results indicate that (1) treatment research focuses almost exclusively on the impact of treatment techniques with scant attention to influences (child/adolescent, parent, family, therapist) that may moderate outcome and (2) several characteristics of the children/adolescents and methods of treatment delivery and approaches depart markedly from those evident in the practice of treatment. Priorities for treatment research to place clinical practice on firmer empirical footing are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychotherapy for children and adolescents: Current progress and future research directions.

Psychotherapy research for children and adolescents has progressed considerably in the past decade. In this article, reviews of treatment outcome research, individual outcome studies, programmatic studies of specific interventions, and treatments for specific clinical dysfunctions are highlighted to convey progress. Current advances in treatment have been augmented greatly by psychological theory and research on the nature of child dysfunction as well as by improved methods for assessing children and specifying and evaluating treatments. In light of the current status of research, several priorities are identified that include expanding the range of research questions asked about treatment, evaluating a broader range of treatments, examining long-term treatment effects, bridging research and practice, extending treatment further to underserved and understudied populations, and integrating developmental theory and research into child treatment research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Improving the transition from basic efficacy research to effectiveness studies: Methodological issues and procedures.

This article proposes methodological strategies that, if used in treatment outcome research, may help in the transition of efficacy research findings into effectiveness trials in clinical and service delivery settings. Alternative methodologies are proposed to examine how treatment effectiveness may vary as a function of degree of treatment structure, treatment protocol compliance, psychotherapy integration into an overall treatment regimen, participant selection and composition, and variations in treatment parameters. The discussion focuses on encouraging the retention of experimental control while stretching psychotherapy outcome research designs to encompass effectiveness issues. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment adherence process research in family therapy: A rationale and some practical guidelines.

Suggests that treatment adherence research has recently established a permanent niche in psychotherapy outcome research as a means for testing whether interventions have been implemented as intended. Advanced-level adherence methods allow investigators to move beyond treatment integrity questions regarding model fidelity and toward treatment process questions regarding therapeutic technique and intervention dosage. Though still in the developmental stage, treatment adherence process procedures appear to be congruent with the methods, goals, and theoretical framework that characterize contemporary psychotherapy process research. Because adherence process research is virtually absent from the family therapy research literature, practical guidelines are presented for conducting observational-based adherence research on family therapy models, using the example of Multidimensional Family Therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Addressing key challenges in evidence-based practice in psychology.

With its promise of enhancing the effectiveness of services, evidence-based practice in psychology (EBPP) appears to offer much to psychologists, patients, and policymakers. The purpose of this article is to examine some of the key challenges facing psychologists who wish to provide evidence-based treatment services, including how research evidence is used in EBPP, whether the results of the treatment research literature can be generalized to typical clinical practice, and how effective evidence-based treatments are in clinical practice. On the basis of recent evidence-based initiatives and treatment research, there is a solid scientific basis for EBPP, although much more research is necessary on the treatment of relatively mild, but common, clinical conditions and on the transporting of evidence-based treatments into clinical practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Commentary: Reconsidering the self-selection factor in addiction treatment research.

The self-selection factor is pervasive in health care and is assumed to be a contributor to achieving therapeutic goals. For example, the therapeutic efficacies of medications or mental health approaches are assessed with those individuals who undergo or use the therapy. In addiction treatment research, however, self-selection is viewed as a methodological problem. The conventional criticism of evaluative research is that self-selection undermines conclusions concerning the efficacy of addiction treatment. This commentary reconsiders the issue of self-selection in addiction treatment within the context of clinical experience, developing theory, and research on motivation and recovery stages. A new perspective is outlined that redefines the importance of self-selection in interpreting the effectiveness of treatment. Implications are discussed for research design, treatment policy, and treatment practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Drug Abuse Treatment Outcome Study (DATOS): Treatment Evaluation Research in the United States.

Much of what is known about typical drug abuse treatment outcomes comes from a series of large-scale national prospective longitudinal treatment evaluation studies supported by the National Institute on Drug Abuse over the past 3 decades. An overview of the historical context, research design, and findings from the Drug Abuse Reporting Program (DARP) and the Treatment Outcome Prospective Study (TOPS) is presented. The Drug Abuse Treatment Outcome Study (DATOS), a multisite cooperative agreement, is the latest and most advanced in this research designed to understand drug abuse treatment. DATOS investigators are conducting analyses in 4 thematic areas: health services research, retention and engagement in treatment, the life course of treated addicts, and policy-relevant treatment outcome studies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Enhancing Treatment Fidelity in Health Behavior Change Studies: Best Practices and Recommendations From the NIH Behavior Change Consortium.

Treatment fidelity refers to the methodological strategies used to monitor and enhance the reliability and validity of behavioral interventions. This article describes a multisite effort by the Treatment Fidelity Workgroup of the National Institutes of Health Behavior Change Consortium (BCC) to identify treatment fidelity concepts and strategies in health behavior intervention research. The work group reviewed treatment fidelity practices in the research literature, identified techniques used within the BCC, and developed recommendations for incorporating these practices more consistently. The recommendations cover study design, provider training, treatment delivery, treatment receipt, and enactment of treatment skills. Funding agencies, reviewers, and journal editors are encouraged to make treatment fidelity a standard part of the conduct and evaluation of health behavior intervention research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Contributions of Canadian applied psychological research to correctional and psychiatric institutions.

Discusses Canadian psychological research relevant to the treatment of persons institutionalized in psychiatric and correctional settings. Studies are divided into 4 categories: prevention, assessment, treatment, and release. It is concluded that although some innovative and influential applied research has been accomplished, the amount of applied research is relatively small and tends to focus on assessment rather than treatment issues. A discussion of some of the factors responsible for the relative paucity of relevant research is followed by a consideration of what might be done to improve the quantity and quality of research efforts in the future. It is suggested that an area of high priority should be the identification of organizational features of institutions that affect the adoption and maintenance of improved practices. (French abstract) (6 p ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Beyond clinical trials: Generalizing from research to practice.

Suggests that clinical trials, or evaluations of psychotherapy techniques in clinical settings with patient populations, play a pivotal role in treatment research. Well-controlled psychotherapy trials provide a test of what treatment can do under conditions in which procedures such as therapist training and monitoring and the integrity of treatment are optimal. Methods designed to reduce the hiatus in how treatments are implemented, monitored, and evaluated in clinical research and practice include developing standardized assessment and treatment packages that can be implemented by practitioners, altering the manner in which clinical training is implemented and evaluated, training clinicians in strategies to evaluate their own clinical work, and conducting clinical replication case studies as a way to evaluate treatment applications in clinical practice. These alternatives combine standardization, training, evaluation, and clinical practice to help increase the generality of research findings to clinical work and to help merge research and clinical priorities. (46 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Moving beyond efficacy and effectiveness in child and adolescent intervention research.

This Special Section of the Journal of Consulting and Clinical Psychology focuses on research that extends beyond documenting the efficacy and effectiveness of specific psychological treatments or preventive interventions for children and youths. In the past 30 years, there have been remarkable advances in the development and evaluation of psychological treatments and preventive interventions for a wide range of child and adolescent problems. At the same time, only a small percentage of youths who suffer from emotional and behavioral problems receive psychological services, and many of these services are not evidence-based. This article discusses key features of the Special Section studies, which examine important issues related to (a) disseminating treatments in diverse community settings (i.e., investigating the transportability of treatment), (b) personalizing mental health care (i.e., investigating predictors and moderators of treatment outcome), and (c) developing evidence-based explanations of treatment (i.e., investigating mediators of treatment). Key issues that are raised in the specific studies are discussed, and important considerations for future research are highlighted. Moving the field forward requires innovation, complex research designs, and a willingness to develop treatment models that reach beyond the current body of treatment outcome and prevention research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Time-limited brief therapy has gone too far: The result is invisible rationing.

Proponents of managed care endorse time-limited brief treatment on the belief that time limits result in little or no harm to psychotherapy outcome. However, the research findings cited as favorable to time limits are based on erroneously classified research, and the related research is incorrectly interpreted. Properly classified and interpreted, the research indicates that time-limited therapy is in fact inferior to clinically determined treatment. Both research and reason indicate that time-limited therapy is not an equally effective alternative treatment but merely a form of rationing. Although rationing may be necessary, when time-limited therapy is promoted as equivalent to clinically determined treatment, the consumer is often unaware of the rationing. The result is the ethically questionable practice of invisible rationing. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment of selective mutism: A best-evidence synthesis.

This study represents the first systematic analysis of the major treatment approaches used for selective mutism with the goal of drawing conclusions about selecting evidence-based procedures for practice. Based on nonparametric statistical tests of effect sizes, the major findings include the following: (a) treatment of selective mutism is more effective than no treatment, (b) behaviorally oriented treatment approaches are more effective than no treatment, and (c) no differential effectiveness was found between two common models of behavior therapy. In addition, researchers have given minimal attention to the impact of selective mutism on educational performance. In this study, which reviewed existing research, information regarding academic achievement was evaluated qualitatively. Recommendations are made for improving the methodological quality of future research on selective mutism within the context of research on evidence-based interventions. Implications for practice in school psychology are presented. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The use of treatment manuals in cognitive therapy: Experience and issues.

This article traces some historical developments in the use of treatment manuals in psychotherapy research and reviews characteristics that have facilitated the development of cognitive therapy manuals. Arguments in favor of and opposed to the further development of treatment manuals are reviewed. Where cognitive therapy research exists that is relevant to these arguments, it is reviewed; where research does not exist, suggestions are provided for research and data that may address these arguments. The article concludes by suggesting three general areas for future treatment-manual research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comparison of completers and noncompleters of exposure-based cognitive and behavioral treatment for phobic and anxiety disorders in youth.

This article examined sociodemographic and clinical characteristics of child treatment completers, and noncompleters who received exposure-based cognitive-behavioral treatment. A total of 137 children (46% girls) and their parents (predominantly Euro-American and Hispanic/Latino) participated in this study (106 completers, 31 noncompleters). The majority of noncompleters, received an average of 5 sessions. Findings were generally consistent with past research in terms of lack of differences between completers; and noncompleters. Results are discussed in the context of previous child attrition research and directions for future research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Individual differences science for treatment planning: Personality traits.

Evolving ethical, legal, and financial demands require a plan before treatment begins. The authors argue that individual differences research requires the inclusion of personality trait assessment for the construction and implementation of any treatment plan that would lay claim to scientific status. A primer of personality individual differences for treatment planning is presented, including an introduction to constructive realism and major research findings from trait psychology and behavior genetics bearing on treatment planning. The authors present 4 important gains for treatment planning that can be realized from the science of individual differences in personality: (a) knowing where to focus change efforts, (b) realistic expectations, (c) matching treatment to personality, and (d) development of the self. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Demonstrating therapeutic validity versus the false placebo–therapy distinction.

Discusses research problems in differentiating between effective and ineffective therapies. It is suggested that distinguishing between therapies and placebos is based on theoretical misconceptions and that research needs to focus on developing and assessing psychotherapies that show treatment effects in specific target problems. Evidence for the specificity of treatment effects and differences between outcome and process psychotherapy research are also discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Beyond efficacy and effectiveness: A multifaceted approach to treatment evaluation.

The recent shift toward evidence-based practice in psychology and other areas of health care highlights the need for strong research evidence supporting treatments. However, research evidence has usually been narrowly defined, focusing almost exclusively on treatment outcomes. Although determining the efficacy and effectiveness of treatments is an essential component of treatment evaluation, the authors propose that other areas of evaluation should also be studied as part of a more comprehensive evaluation approach. In this article, the authors integrate recommendations on how treatment evaluation can move beyond studying only outcomes into a model for multifaceted treatment evaluation. Specifically, the authors propose the need to study not only outcomes, but also provider, consumer, and economic considerations. By expanding the focus of treatment evaluation research, the authors hope to offer a model that will guide researchers in developing research evidence that will facilitate the successful widespread implementation of evidence-based approaches. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Relapse prevention.

Reviews the book, Relapse prevention by G. Alan Marlatt and Judith R. Gordon. The book is well suited for its intended audience-clinicians and researchers working in the field of addictions. Clinicians and program developers will appreciate the clear clinical conceptualization of the addiction treatment program and the comprehensive and detailed array of treatment methods that are directly linked to the model. Clinicians working in specialized addiction programs will benefit from the chapters from the contributing authors which outline programmatic approaches for dealing with these behaviors. Clinicians outside the addiction field certainly will find the model and strategies useful in conceptualizing and facilitating the maintenance of behavior change in all types of clients. For researchers, the book will be a rich resource of research ideas and future research directions, and a model for integrating research with practice. It is still uncommon, but much appreciated, to see a true scientist-practitioner like Marlatt who uses research findings to improve treatment and treatment observations to pose research questions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)