The authors review the status, strength, and quality of evidence-based practice in child and adolescent mental health services. The definitional criteria that have been applied to the evidence base differ considerably across treatments, and these definitions circumscribe the range, depth, and extensionality of the evidence. The authors describe major dimensions that differentiate evidence-based practices for children from those for adults and summarize the status of the scientific literature on a range of service practices. The readiness of the child and adolescent evidence base for large-scale dissemination should be viewed with healthy skepticism until studies of the fit between empirically based treatments and the context of service delivery have been undertaken. Acceleration of the pace at which evidence-based practices can be more readily disseminated will require new models of development of clinical services that consider the practice setting in which the service is ultimately to be delivered.

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The parent–child relationship is an important context for children's emotional development. The current study assessed 43 parent–child dyads while watching a positive film clip and a negative film clip, in order to examine whether partner's physiological reactivity demonstrated dyadic synchrony, and whether this was associated with children's prosocial empathy. Respiratory sinus arrhythmia was measured in both caretakers and children (ages 9–14) and a continuous time series was estimated in order to maximize temporal resolution of physiological dynamics. Dyads varied in both the magnitude and direction of synchrony, with correlation coefficients ranging from moderately negative; r = −.44 (increases in one partner correspond to decreases in the other), to moderately positive; r = .55 (increases in one partner correspond to increases in the other). For both conditions, negative synchrony was correlated with higher child‐reported empathy. For the negative mood condition, this effect was moderated by caretaker's emotional acceptance such that positive synchrony was associated with lower levels of empathy among dyads in which caretaker emotional acceptance was lower. These results suggest that positive physiological synchrony during a negative mood condition may not be adaptive for children when their caretaker lacks the skills to appropriately socialize their child's emotional development.

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