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Objective This study identified modifications to an evidence-based psychosocial treatment (cognitive therapy) within a community mental health system after clinicians had received intensive training and consultation. Methods A coding system, consisting of five types of contextual modifications, 12 types of content-related modifications, seven levels at which modifications can occur, and a code for changes to training or evaluation processes, was applied to data from interviews with 27 clinicians who treat adult consumers within a mental health system. Results Nine of 12 content modifications were endorsed, and four (tailoring, integration into other therapeutic approaches, loosening structure, and drift) accounted for 65% of all modifications identified. Contextual modifications were rarely endorsed by clinicians in this sample. Modifications typically occurred at the client or clinician level. Conclusions Clinicians in community mental health settings made several modifications to an evidence-based practice (EBP), often in an effort to improve the fit of the intervention to the client’s needs or to the clinician’s therapeutic style. These findings have implications for implementation and sustainability of EBPs in community settings, client-level outcomes, and training and consultation.

The current study examined developmentally informed pathways from peer victimization and exclusion to adolescent alcohol use. Using multiple informants (target and peer report of negative peer experiences) and a longitudinal sample of 387 adolescents, we examined 2 developmental pathways from these negative peer experiences to alcohol use, 1 through externalizing symptoms and the other through internalizing symptoms. When analyzed in separate models, results suggested that self-reported chronic peer victimization and exclusion were positively related to alcohol use through internalizing symptoms and coping motivated drinking. The risk pathway replicated for exclusion when using peer report of negative peer experiences. When victimization and exclusion were tested simultaneously in the same model, the risk pathway through internalizing symptoms and coping drinking motives was only supported for chronic exclusion and this finding replicated across reporters. No support was found for negative peer experiences operating through externalizing symptoms. Findings from the present study help clarify developmental pathways linking negative peer experiences to alcohol use and suggest that experiencing chronic exclusion may have a particularly deleterious impact on alcohol use during adolescence. (PsycINFO Database Record

Introduction: Despite the central role of inhibitory control in models of adolescent development, few studies have examined the longitudinal development of inhibitory control within adolescence and its prospective association with maladaptive outcomes. The current study evaluated: 1) growth in inhibitory control from early-to middle-adolescence, and 2) the relation between inhibitory control and later delinquency. Methods: Participants included 387 parent-child dyads (11-13 years old at Wave 1; 55% female; USA). Across three annual assessments, teens completed the Stop Signal Task (SST), and parents completed the Inhibitory Control subscale of the Early Adolescent Temperament Questionnaire-Revised. Teens self-reported their delinquent behaviors in early (Mage = 12.1) and middle adolescence (Mage = 14.1) and emerging adulthood (Mage = 18.2). Results: Latent growth curve models indicated that SST performance improved curvilinearly from early to middle adolescence (ages 11-15), with growth slowing around middle adolescence. However, no growth in parent-reported inhibitory control was observed. Lower task-based and parent-reported inhibitory control in early adolescence predicted greater increases in delinquency from middle adolescence to emerging adulthood. However, rate of growth in taskbased inhibitory control was unrelated to later delinquency. Conclusions: This longitudinal study provides a novel examination of the development of inhibitory control across early and middle adolescence. Results suggest that the degree to which inhibitory control confers risk for later delinquency may be captured in early adolescence, consistent with neurodevelopmental accounts of delinquency risk. Differences across assessment tools also highlight the need for careful measurement considerations in future work, as taskbased measures may be better suited to capture within-person changes over time. IntroductionInhibitory control is critical for engaging in adaptive, goal-directed behavior. Successful inhibition involves suppressing a dominant or prepotent response in order to execute a subdominant but adaptive response (Barkley, 1997). Poor inhibitory control

Substance use disorders commonly onset during adolescence, yet the best available treatments yield only modest and transient effects. Elucidating treatment mediators is essential for improving treatment options. This review summarizes over 20 years of research on mediators of adolescent substance use treatment; k = 17 studies assessing both treatment or treatment ingredient to mediator (a path) and mediator to treatment outcome (b path) paths were included. Mediators were categorized using the Science of Behavior Change target class framework. Overall, mediation tests supported four of eight self-regulation, two of 10 stress resilience and reactivity, six of 19 interpersonal and social process, and two of four treatment engagement and adherence mediators. To enhance the capacity of this work to inform clinical practice, we recommend future research examine theoretically informed mechanisms using temporally sequenced data among other methodological guidelines. Public Health Significance StatementThe current study offers some support for self-regulatory and treatment engagement and adherence mediators of adolescent substance use treatment, however, heterogeneity in the sample of studies precludes any firm conclusions. A concerted effort to examine key processes of evidence-based adolescent substance use treatments can yield enhanced knowledge to guide practice, as well as intervention refinement and implementation within the community.