Adaptive Interventions in Child and Adolescent Mental Health

Abstract

The treatment or prevention of child and adolescent mental health (CAMH) disorders often requires an individualized, sequential approach to intervention, whereby treatments (or prevention efforts) are adapted over time based on the youth’s evolving status (e.g., early response, adherence). Adaptive interventions are intended to provide a replicable guide for the provision of individualized sequences of interventions in actual clinical practice. Recently, there has been great interest in the development of adaptive interventions by investigators working in CAMH. The development of such replicable, real-world, individualized, sequences of decision rules to guide the treatment or prevention of CAMH disorders represents an important “next step” in interventions research. The primary purpose of this special issue is to showcase some recent work on the science of adaptive interventions in CAMH. In this overview article, we review why individualized sequences of interventions are needed in CAMH, provide an introduction to adaptive interventions, briefly describe each of the articles included in this special issue, and describe some exciting areas of ongoing and future research. A hopeful outcome of this special issue is that it encourages other researchers in CAMH to pursue creative and significant research on adaptive interventions.

Developing Optimized Adaptive Interventions in Education

“…An adaptive intervention is a prespecified set of decision rules that guide whether, how, or when—and based on which measure(s)—to offer different intervention options initially and over time (Almirall & Chronis-Tuscano, 2016; Collins, Murphy, & Bierman, 2004; Nahum-Shani et al, 2012). Typically, an adaptive intervention is needed because treatment effects are heterogeneous: for example, schoolchildren differ in how they respond or adhere to different intervention options.…”

Parent ADHD and Evidence-Based Treatment for Their Children: Review and Directions for Future Research

“…Assuming that some combination of parent and child ADHD treatment will be needed in families in which both the parent and child have ADHD, we are currently conducting a pilot Sequential Multiple Randomization Trial (SMART; Almirall & Chronis-Tuscano, 2016) to inform the clinical care of these families. The SMART design involves two or more randomizations in order to examine optimal sequencing of interventions.…”

“…Moreover, the SMART design will allow us to examine baseline demographic characteristics and variables observed during the first 8 weeks (e.g., treatment adherence, attitudes, and response) that may moderate the optimal sequencing of treatments. Thus, this design will ultimately enhance a clinician's ability to personalize treatment for these families in a data-driven manner (Almirall & Chronis-Tuscano, 2016). …”

Inaugural Editorial: Making the Journal of Clinical Child & Adolescent Psychology Your “Home Journal”

“…As mentioned previously, JCCAP leverages the special issue/ section format to publish articles that provide updates to the field on general topics of interest to its readers and guidance for clinical practice (e.g., Lonigan et al, 1998;Mash & Hunsley, 2005;Silverman & Hinshaw, 2008). JCCAP also uses the special issue/section format to highlight emerging areas of the field to spur new research and theory in these areas (e.g., Almirall & Chronis-Tuscano, 2016;. Consequently, JCCAP now welcomes proposals for either special issues (10 papers) or special sections (six papers) on a specific topic of relevance to the field.…”

“…The road toward building these bonds begins with the aims and scope of the journal, perhaps best elucidated by Silverman (2002): emerging, innovative research topics of relevance to child and adolescent mental health. Examples of these topics include the role of regulatory control in adolescent depression (Klimes-Dougan & Garber, 2016), adaptive interventions (Almirall & Chronis-Tuscano, 2016), and applied clinical neuroscience , each of which JCCAP recently covered as a special issue or section. Below, I discuss developments in JCCAP's approach to the special issue/section format.…”