Evidence‐based treatments for children and adolescents: An updated review of indicators of efficacy and effectiveness.

Abstract

This updated review of evidence-based treatments follows the original review performed by the Hawaii Task Force. Over 750 treatment protocols from 435 studies were coded and rated on a 5-level strength of evidence system. Results showed large numbers of evidencebased treatments applicable to anxiety, attention, autism, depression, disruptive behavior, eating problems, substance use, and traumatic stress. Treatments were reviewed in terms of diversity of client characteristics, treatment settings and formats, therapist characteristics, and other variables potentially related to feasibility and generalizability. Overall, the literature has expanded considerably since the previous review, yielding a growing list of options and information available to guide decisions about treatment selection.

Evidence Base Update: 50 Years of Research on Treatment for Child and Adolescent Anxiety

“…These findings reveal that reliance on the single outcome indicator of posttreatment diagnostic status might potentially underestimate the positive effect of this treatment for child and adolescent anxiety. Consistent with the recommendations of Hoagwood, Jensen, Petti, and Burns (1996) and others (e.g., who advocate the examination of multiple indicators of treatment outcome, including those relevant to the youth and the systems in which they function, these findings speak to the need for further analysis of the treatment outcome literature for child and adolescent anxiety disorders to address questions relevant to the potential effectiveness of a given intervention for a particular youth with a particular problem (e.g., Chorpita et al, 2011). Ollendick and King (1998) presented the first review of treatments for child and adolescent phobic and anxiety disorders that used guidelines set forth by the American Psychological Association (APA) Task Force on Promotion and Dissemination of Psychological Procedures, Division of Clinical Psychology, American Psychological Association (1995) to evaluate the efficacy of a given psychological intervention.…”

“…Although a review of full treatments, as presented here, cannot establish the efficacy of specific therapeutic components (Chorpita, Becker, & Daleiden, 2007), this update will (a) evaluate mediators and moderators of treatment outcome, and (b) identify those specific treatment components or techniques that are most often present in protocols that have demonstrated empirical support. More specifically, in addition to presenting findings at the level of treatment families (consistent with the move away from discussing ''brand-name'' therapies; e.g., Chorpita et al, 2002Chorpita et al, , 2011Rogers & Vismara, 2008), this report also presents frequency profiles of the practice elements associated with the most efficacious treatments, as have previous reviews of the outcome literature for youth internalizing and externalizing problems (e.g., Borntrager, Chorpita, Higa-McMillan, Daleiden, & Starace, 2013;Brookman-Frazee, Haine, Baker-Ericzen, Zoffness, & Garland, 2010). Whereas the construct of treatment family serves to aggregate similar treatment protocols that employ common therapeutic elements (e.g., individual protocols that each involve self-monitoring, ANXIETY DISORDERS UPDATE developing coping statements, and associated behavioral exercises would be grouped together as one treatment family), the concept of practice element is intended to assist in identifying the specific ''clinical ingredients'' (e.g., Cognitive, Exposure, Relaxation; Chorpita, Daleiden, & PracticeWise, 2009, p. 7) of which each treatment protocol is comprised.…”

“…In the current context of increasing numbers of evidence-based treatments, Becker et al suggested that our field needs to revise the criteria used not only to assign strength of evidence levels to these treatments but also to guide the selection of the most appropriate treatments for clients, caregivers, and clinicians. In their review, Becker et al (2011) Chorpita et al, 2011). Although only four (17.4%) of these 23 treatment families were examined in studies that also employed measures of functioning, all four treatment families demonstrated empirical support when using functioning as the outcome criterion.…”

Evidence-based psychotherapy in children and adolescents: advances, methodological and conceptual limitations, and perspectives

“…Meta-analyses and reviews indicate that many kinds of psychotherapy produce therapeutic effects in children and adolescents (9,34). However, more in depth-analyses of treatment effects are necessary to identify under what conditions these treatments work best (i.e.…”

“…[5][6][7]). These results have coalesced into evidence-based treatments for children and adolescents applicable to several diagnostic categories including anxiety disorders, depressive disorders, eating disorders, autism spectrum disorders, substance abuse, and attention deficit hyperactivity disorders [8,9]. The majority of these treatments under study in this age group can be described by the umbrella term 'cognitive-behavioural therapy' (CBT); they include both programmes designed specifically for children and adolescents and generic approaches for all age groups such as CBT for anxiety disorders [8,10].…”