Does it work in the real world? The effectiveness of treatments for psychological problems in children and adolescents.

Abstract

Despite the availability of hundreds of treatment studies in the scientific literature, we know little about whether these treatments work in regular practice. We present an updated review of treatment effectiveness studies for psychological problems in children and adolescents. A literature search yielded 20 recent articles describing effectiveness studies for the treatment of anxiety disorders, depression, and disruptive behavior problems. We compared data from these effectiveness studies with two benchmarks reported in meta-analyses of efficacy trials: the numbers of clients who completed services and the improvements found in those who completed services. All studies of the treatment of internalizing disorders reported completion rates above 80%; the majority of parenting interventions for the treatment of disruptive behavior problems reported that more than 75% of parents who began services completed them. The improvement rates reported in effectiveness studies for internalizing problems were comparable to the benchmarks reported in efficacy studies. There was greater variability in the treatment of disruptive behavior problems, with several studies outperforming the benchmark, and a smaller number yielding poorer results. Practitioners should be encouraged to see promising results that suggest evidence-based treatments for child and adolescent disorders can be effective when used in typical clinical settings.

Multiple Family Groups for Children with Disruptive Behavior Disorders: Child Outcomes at 6-Month Follow-Up

“…In contrast, the within-group effect sizes for the MFG condition assessing changes in child behavior from baseline to 6-month follow-up range from 0.43 to 1.16. The within group effect size for reduction in ODD symptoms ( d = 0.50) in the current study is also lower than the average within group effect size ( d = 0.68) reported by Lee et al (2013).…”

“…Hagen et al (2011) reported no significant between-group differences on analyses including 1-year follow-up measures on child behavior outcomes using ITT analyses, and only small effect sizes (i.e., 0.08–0.29) among those who actually received treatment. Effect sizes for between group analyses in the current study are also consistent with those reported (average d = 0.30) by Lee et al (2013) in their analysis of 13 effectiveness studies conducted in routine clinic settings for treating youth DBDs.…”

Supporting Parenting to Promote Children's Social and Emotional Well-being

“…COPE sessions are designed for parents of children aged 3-12 years, and teenagers (13)(14)(15)(16)(17)(18) 132 subgroup discussions of solution development, leader modelling, and application of strategies in homework assignments (Cunningham, Bremner, Secord, & Harrison, 2009). Systematic reviews, meta-analyses, and benchmarking studies provide evidence that parenting programs derived from social learning theory produce changes in parent behaviour, child behaviour, and parent adjustment (Lee, Horvath, & Hunsley, 2013;Michelson, Davenport, Dretzky, Barlow, & Day, 2013;Sanders, Kirby, Tellegen, & Day, 2014). Within the context of the MHCC's first priority-to promote mental health, prevent problems, and reduce stigma-the MHCC blueprint accords central importance to increasing parents' capacity to encourage the healthy social and emotional wellbeing of their children.…”

Evidence-Based Practice: Separating Science from Pseudoscience

“…44 Lee et al 45 examined treatment effectiveness studies in regular clinical settings for children and adolescents. Across studies, more than 75% of patients completed the services.…”