Parent-adolescent conflict poses risk for youth maladjustment. One potential mechanism of this risk is that stress in the form of increased arousal during conflict interactions results in adolescents’ impaired decision-making. However, eliciting consistent adolescent stress responses within laboratory-based tasks of parent-adolescent conflict (i.e., conflict discussion tasks) is hindered by task design. This limitation may stem from how conflict topics are assessed and selected for discussion. Within a sample of 47 adolescents (ages 14–17) and parents, we investigated whether a modified version of a conflict discussion task could elicit physiological (i.e., arousal) and behavioral (i.e., hostility) displays of adolescents’ conflict-related stress responses. We assessed parent-adolescent conflict via structured interview to identify topics for dyads to discuss during the task. We randomly assigned dyads to complete a 5-minute task to discuss either a putatively benign topic (i.e., control condition) or a conflict topic while undergoing direct assessments of continuous arousal. Trained raters coded dyad members’ hostile behavior during the task. Adolescents in the conflict condition exhibited significantly greater levels of arousal than adolescents in the control condition. We observed an interaction between discussion condition and baseline conflict. Specifically, higher baseline conflict predicted greater hostile behavior for adolescents in the conflict condition, yet we observed the inverse relation for adolescents in the control condition. Our modified laboratory discussion task successfully elicited both physiological and behavioral displays of adolescent conflict-related stress. These findings have important implications for leveraging experimental paradigms to understand causal links between parent-adolescent conflict and adolescent psychopathology, and their underlying mechanisms.

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Evidence-based interventions (EBIs) have demonstrated beneficial outcomes among children and adolescents. That said, not all manual-based EBIs that demonstrate efficacy in research settings have yielded the same results in community-based settings. An EBI that is found to be efficacious in research but less effective once disseminated into the community may reflect either (1) too rigid adherence to a manualized protocol that does not ‘fit’ the needs of the individuals receiving the intervention in the community or (2) overly loose application (non-adherence) of the programme that compromises fidelity. Perfect adherence to a protocol may be unattainable in any settings given the variety of factors that arise in providing mental health services (e.g. staff turnover, limited practitioner time). What has emerged is a valid tension between following an efficacious manual-based treatment and delivering an intervention that is adapted to the needs of an individual. This tension often can arise for practitioners with limited therapy experience who are delivering manual-based low intensity interventions. Intervention adaptations are necessary for widespread application, yet adaptations must be conducted thoughtfully to maintain implementation fidelity. To achieve this balance, the authors encourage practitioners to operate from a ‘flexibility within fidelity’ framework. Flexibility within fidelity requires that the active ingredients of an EBI are presented, while the ‘adaptable periphery’ (i.e. precise details or manner in which the intervention is delivered) is tailored to an individual client’s needs.

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