Integrating Evidence and Practice of Youth Psychotherapy

University Of California San Diego, La Jolla CA

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Abstract

DESCRIPTION (provided by applicant): The proposed study addresses the lack of knowledge about psychotherapeutic treatment processes for youth in community settings and, more specifically aims to improve the integration between the evidence-base and common practice of youth psychotherapy for children ages 4-13 with disruptive behavior problems. The study has been designed, and will be conducted in partnership with a team of practitioners from community clinics, thus enhancing the clinical utility. The aims of the project are to: (a) examine the extent to which evidence-based and practitioner-based principles of effective psychotherapy for these youth are consistent and inconsistent; (2) characterize actual practice of psychotherapy for these youth in community, publicly funded clinics, and determine the extent to which practice reflects evidence-based and practitioner-based principles; (3) examine how practice consistent and inconsistent with these principles is associated with changes in child and family outcomes; and (3a) examine how these linkage between practice and outcomes may be moderated by child and family characteristics such as race/ethnicity and parental psychopathology. The design includes a prospective, longitudinal study of 288 children entering a new episode of out-patient care for treatment of disruptive behavior problems. Thirty-six clinicians from six out-patient clinics will be selected to represent the distribution of clinicians across the clinics by discipline. Eight patients for each of these 36 clinicians will be followed for 16 months. Psychotherapy process data will be collected through videotapes of therapy sessions; randomly selected sessions will be coded for type, breadth, and depth of intervention strategy using a comprehensive coding system. Data on therapeutic alliance and service use (dose and intensity) will also be collected. Outcome data assessing child symptomatology, functional impairment. family functioning, and perceived treatment benefit will be collected at entry and every 4 months up to 11 months, regardless of length of treatment. Data will be analyzed using mixed effects regression models to examine how variations in treatment elements are related to outcome trajectories.