This work examines the transportability of cognitive-behavioral therapy (CBT) for panic disorder to a community mental health center (CMHC) setting by comparing CMHC treatment outcome data with the results obtained in two controlled efficacy trials. Participants were 110 clients with a primary diagnosis of panic disorder with or without agoraphobia; clients were not excluded on the basis of medication use or changes, severity or frequency of panic attacks, age, or the presence of agoraphobia. Clients completed a 15-session CBT protocol. Despite differences in settings, clients, and treatment providers, the treatment outcomes for clients completing treatment in the CMHC and the efficacy studies were comparable: Of the CMHC clients who completed treatment, 87% were panic-free at the end of treatment, and clients showed significant reductions in anticipatory anxiety, agoraphobic avoidance, generalized anxiety, and symptoms of depression. The present study suggests that panic control treatment can be transported to a CMHC. Challenges facing the transportability of researchbased treatment to CMHC clients, settings, and treatment providers are discussed. Controlled treatment outcome research commonly takes place under conditions that maximize both internal validity and the specificity of conclusions about causal mechanisms. It can be argued that outcome findings from internally valid efficacy studies cannot be assumed to generalize to other settings, populations, and treatment providers (Hollon, 1996; Jacobson & Christensen, 1996; Seligman, 1996). How well do the results of empirically supported treatments (ESTs; see Jacobson & Christensen, 1996) hold up in natural settings? Generalizability studies are needed to determine the transportability of ESTs to community settings (Wilson, 1995, 1996). Some consider efficacy research overvalued because of limitations in generalizability and have proposed the "effectiveness study" as a preferable alternative (Hoagwood, Hibbs, & Brent, 1995). The effectiveness study, in which efficacious interventions are examined in real-world service settings, is offered as a viable solution to the shortcomings of the traditional, controlled conditions of efficacy research. Proponents argue that effectiveness study methodology can be used to determine treatment effectiveness without sacrificing generalizability to actual clinical settings. Unfortunately, the effectiveness study method is not without its problems. As critics have pointed out, the effectiveness ap

The last several years have seen much debate over the appropriateness and viability of empirically supported manual‐based psychotherapies for clinical practice. While the majority of discussions have focused on the strengths or weaknesses of evidence‐based treatments, and the differences between research and clinical practice, scant attention has been paid to addressing the actual concerns of practitioners in clinical settings. Based on the available research, and our experiences with training and supervision in manual‐based treatments, we discuss practitioners' most common concerns, including (a) effects on the therapeutic relationship, (b) unmet client needs, (c) competence and job satisfaction, (d) treatment credibility, (e) restriction of clinical innovation, and (f) feasibility of manual‐based treatments. Rather than arguing that these concerns are unwarranted, we suggest future directions the field must take if evidence‐based treatments are to be viable and effective in clinical practice. Starting with the assumption that these treatments have much (but not everything) to offer practitioners in clinical settings leads to qualitative and quantitative research questions involving all parties with an interest in evidence‐based practice.

The current study examined the feasibility and effectiveness of transporting an empirically supported treatment for depression, cognitive therapy (CT), to a community mental health center setting. CT was delivered to 192 adult outpatients with major depression, and a benchmarking strategy compared results with those of 2 randomized controlled trials (RCTs). The 3 samples were largely similar in terms of initial severity of depression, and CT was as effective in reducing depressive symptoms in the current sample as in the RCTs. More favorable outcome was associated with less severe initial depression, more therapy sessions, more years of education, and absence of a comorbid personality disorder. This study demonstrates that an empirically supported treatment can be transported effectively to a clinical setting.

The transportability of cognitive-behavioral therapy (CBT) for panic disorder to a community mental health center (CMHC) setting at 1-year follow-up was examined by comparing CMHC treatment outcome data with results obtained in controlled efficacy studies. Participants were 81 CMHC clients with a primary diagnosis of panic disorder with or without agoraphobia who completed CBT for panic disorder. Despite differences in settings, clients, and treatment providers, both the magnitude of change from pretreatment to follow-up and the maintenance of change from posttreatment to follow-up in the CMHC sample were comparable with the parallel findings in the efficacy studies. At follow-up, 89% of the CMHC clients were panic free and a substantial proportion of the sample successfully discontinued benzodiazepine use.

Understanding what children of alcoholics and other substance users experience has dominated the scientific literature and popular press for the past several decades. To date, the empirical studies have relied primarily on quantitative data to understand the individual and environmental factors associated with the lives, the developmental trajectories, and the growth of children of alcoholics and other substance users. Many of these studies focus on their risks, and very few of them focus on their strengths. Additionally, very few studies have used qualitative techniques to collect data. While quantitative studies have given us great insight, perhaps we could learn a great deal more if we employed data collection methods which would actually provide us with the child's perception of their strengths, or resilience, and what they think it takes to grow into happy, healthy adults. For this reason, this study presents data from the interviews of 50 children of substance users who present their views on resilience.