When the torch is passed, does the flame still burn? Testing a “train the supervisor” model for the Child STEPs treatment program.

Weisz, John R.; Ugueto, Ana M.; Herren, Jenny; Marchette, Lauren Krumholz; Lee, Erica; Thomassin, Kristel; Alleyne, Alisha; Cheron, Daniel M.; Tweed, James; Hersh, Jacqueline; Raftery‐Helmer, Jacquelyn N.; Weissman, Adam S.; Jensen‐Doss, Amanda

doi:10.1037/ccp0000331

Cited by 32 publications

(30 citation statements)

References 35 publications

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“…This RCT adds to a growing body of evidence on strategies for transporting Child STEPs to community mental health settings. A previous study (Weisz et al, 2018) indicated that training staff clinicians to supervise MATCH implementation in their clinics can provide ample levels of clinician fidelity and youth outcomes. Another study (Weisz et al, 2019) suggested that thinning out consultation by multiplying the number of clinicians per consultation hour might undermine fidelity and outcomes.…”

Section: Discussionmentioning

confidence: 99%

Clinician training, then what? Randomized clinical trial of child STEPs psychotherapy using lower-cost implementation supports with versus without expert consultation.

Weisz¹,

Thomassin²,

Hersh³

et al. 2020

Journal of Consulting and Clinical Psychology

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Implementation of evidence-based treatments in funded trials is often supported by expert case consultation for clinicians; this may be financially and logistically difficult in clinical practice. Might less costly implementation support produce acceptable treatment fidelity and clinical outcomes? Method: To find out, we trained 42 community clinicians from four community clinics in Modular Approach to Therapy for Children (MATCH), then randomly assigned them to receive multiple lower-cost implementation supports (LC) or expert MATCH consultation plus lower-cost supports (CLC). Clinically referred youths (N ϭ 200; ages 7-15 years, M ϭ 10.73; 53.5% male; 32.5% White, 27.5% Black, 24.0% Latinx, 1.0% Asian, 13.5% multiracial, 1.5% other) were randomly assigned to LC (n ϭ 101) or CLC (n ϭ 99) clinicians, and groups were compared on MATCH adherence and competence, as well as on

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Section: Discussionmentioning

confidence: 99%

Clinician training, then what? Randomized clinical trial of child STEPs psychotherapy using lower-cost implementation supports with versus without expert consultation.

Weisz¹,

Thomassin²,

Hersh³

et al. 2020

Journal of Consulting and Clinical Psychology

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“…Evidence supporting the effectiveness (Chorpita et al, 2017;Weisz et al, 2012), sustainability (Weisz et al, 2018), and perceived value (Chorpita et al, 2015;Southam-Gerow et al, 2014) of core EBIs in routine practice continues to mount. Still, the potency of the FT approach in naturalistic form remains virtually untested (Riedinger et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

Core Elements of Family Therapy for Adolescent Behavior Problems: Empirical Distillation of Three Manualized Treatments

Hogue¹,

Bobek²,

Dauber³

et al. 2019

Journal of Clinical Child & Adolescent Psychology

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Objective: Family therapy has the strongest evidence base for treating adolescent conduct and substance use problems, yet there remain substantial barriers to widespread delivery of this approach in community settings. This study aimed to promote the feasibility of implementing family-based interventions in usual care by empirically distilling the core practice elements of three manualized treatments. Method: The study sampled 302 high-fidelity treatment sessions from 196 cases enrolled in one of three manualized family therapy models: Multidimensional Family Therapy (102 sessions/56 cases), Brief Strategic Family Therapy (100 sessions/94 cases), and Functional Family Therapy (100 sessions/46 cases). Adolescents were 57% male; 41% were African American, 31% White Non-Hispanic, 9% Hispanic American, 6% another race/ethnicity, and 13% unknown. The observational fidelity measures of all three models were used to code all 302 sessions. Fidelity ratings were analyzed to derive model-shared treatment techniques via exploratory factor analyses on half the sample; the derived factors were then validated via confirmatory factor analyses supplemented by Bayesian Structural Equation Modeling on the remaining half. Results: Factor analyses distilled four clinically coherent practice elements with strong internal consistency: Interactional Change (6 treatment techniques; Cronbach's α = .93), Relational Reframe (7 techniques; α = .79), Adolescent Engagement (4 techniques; α = .68), and Relational Emphasis (4 techniques; α = .67). Conclusions: The four empirically derived factors represent the core elements of three manualized family therapy models for adolescent behavior problems, setting the foundation of a more sustainable option for delivering evidence-based family interventions in routine practice settings.

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“…Data were pooled from four previous RCTs (Chorpita et al, 2013;Weisz et al, 2019;Weisz, Santucci, et al, 2018;Weisz, Ugueto, et al, 2018) of standard and modular ESTs for youth delivered by therapists in community-based mental health clinics. RCTs shared overlapping procedures, including random assignment of therapists to condition, inclusion and exclusion criteria, EST modalities, and outcome measures (for RCT information, see Table S1 in the online supplemental materials).…”

Section: Methodsmentioning

confidence: 99%

“…Pretreatment symptom severity, treatment effectiveness, and treatment acceptability were examined for subsamples of 368 CG and 64 GM youth, who were classified based on their responses to a proxy indicator of GM status (i.e., youth's wish to be the opposite sex). Chorpita et al, 2017;Weisz et al, 2019;Weisz, Santucci, et al, 2018;Weisz, Ugueto, et al, 2018), and four were included because they administered the measures we used for GM classification and primary outcomes. These RCTs examined the effectiveness and acceptability of ESTs in comparison to UC (Chorpita et al, 2013;Weisz et al, 2019) or when delivered by therapists receiving varying levels of supervision (Weisz, Ugueto, et al, 2018) or consultation (Weisz, Santucci, et al, 2018).…”

Section: Participantsmentioning

confidence: 99%

The effectiveness and acceptability of empirically supported treatments in gender minority youth across four randomized controlled trials.

Hollinsaid

Weisz

Chorpita

et al. 2020

Journal of Consulting and Clinical Psychology

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Objective: Gender minority youth (i.e., children/adolescents whose gender identity and/or expression is inconsistent with their birth-assigned sex) experience elevated rates of emotional and behavioral problems relative to cisgender youth (who identify with their birth-assigned sex), which are not intrinsic to gender identity but attributable to unique minority stressors. Although empirically-supported treatments have proven effective in treating these mental health concerns generally, randomized controlled trials have not examined effects for gender minority youth.Method: To address this gap, we pooled data from clinically-referred youth (N = 432; M(SD)age = 10.6(2.2); 55.1% White) assigned to empirically-supported treatment conditions across four previous randomized controlled trials of modular psychotherapy. A proxy indicator of gender identity (i.e., youth's wish to be the opposite sex) was used to classify gender minority (n = 64) and cisgender (n = 368) youth. Youth-and caregiver-reported pretreatment internalizing and externalizing problems, treatment effectiveness on these domains, and treatment acceptability were compared across groups.Results: Gender minority youth reported more severe pretreatment internalizing and externalizing problems compared to cisgender youth; in contrast, their caregivers reported less severe problems. Though treatment was equally effective for both groups on most outcomes, gender minority youth's caregiver-reported externalizing problems improved more slowly and less reliably, and their self-reported internalizing problems were more likely to remain clinically elevated. Further, gender minority youth reported lower treatment satisfaction.Conclusions: While findings suggest that empirically-supported treatments may effectively address many mental health problems for gender minority youth, they also underscore the need for treatment enhancements that improve acceptability and outcomes.Public Significance Statement: This study examined the effectiveness and acceptability of empirically-supported mental health treatments for gender minority youth (who endorsed a wish to be the opposite sex) and cisgender youth. Gender minority youth reported more severe problems before treatment, demonstrated slower improvement in caregiver-reported behavior problems, and endorsed lower treatment satisfaction. Findings support the potential need for provider-focused trainings relevant to gender minority youth.

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When the torch is passed, does the flame still burn? Testing a “train the supervisor” model for the Child STEPs treatment program.

Abstract: Implementation of empirically supported transdiagnostic treatment may be sustained when supervision is transferred from external experts to trained clinic staff, potentially enhancing cost-effectiveness and staying power in clinical practice. (PsycINFO Database Record

Cited by 32 publications

References 35 publications

Clinician training, then what? Randomized clinical trial of child STEPs psychotherapy using lower-cost implementation supports with versus without expert consultation.

Clinician training, then what? Randomized clinical trial of child STEPs psychotherapy using lower-cost implementation supports with versus without expert consultation.

Core Elements of Family Therapy for Adolescent Behavior Problems: Empirical Distillation of Three Manualized Treatments

The effectiveness and acceptability of empirically supported treatments in gender minority youth across four randomized controlled trials.

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