Toward large-scale implementation of empirically supported treatments for children: A review and observations by the Hawaii Empirical Basis to Services Task Force.

Abstract

only the specific results obtained, but also the process by which a university, Department of Health, and family partnership was established to address specific issues of relevance to statewide implementation of empirically based services. The review of treatment efficacy is consistent with the recent child treatment literature, and these findings were extended through a systematic cataloguing of effectiveness parameters across more than one hundred treatment outcome studies. The importance of such findings and the process by which they were obtained are discussed in the context of a statewide effort to improve mental health practice for children through the extension and application of much of the work by Division 12 of the American Psychological Association with respect to empirically supported treatments.

A Theoretical Model of Common Process Factors in Youth and Family Therapy

“…Lonigan, Elbert, and Johnson (1998) translated the division 12 criteria to the youth treatment literature. Other researchers in the child and adolescent treatment field have also produced reviews of ESTs (Burns, Hoagwood, & Mrazek, 1999;Chorpita et al, 2002).…”

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

“…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 addition to more traditional models of ''leveling'' treatments to denote their efficacy (e.g., Chambless & Hollon, 1998), other factors such as feasibility, generalizability, cost, and magnitude and range of the effects must be taken into consideration as well to give a more complete assessment of the suitability of any given treatment for application in practice settings (see Chorpita et al, 2002). Indeed, one review reported that after receiving an empirically supported treatment (cognitive-behavioral therapy [CBT]) for an anxiety disorder, only 56.5% of children were diagnosis free, compared with 34.8% of participants assigned to a waitlist control condition (Cartwright-Hatton, Roberts, Chitsabesan, Fothergill, & Harrington, 2004).…”

Conceptualizing Culturally Infused Engagement and Its Measurement for Ethnic Minority and Immigrant Children and Families

“…Contemporary thinkers have posited that racial and ethnic disparities in mental health services may result not only from logistical barriers, but also from the ubiquitous pressures of poverty and racism (Johnson et al 2000), stigma associated with receiving mental health care (McCabe 2002), and lack of knowledge about mental health . The effects are particularly concerning: While there is variation among ethnic and cultural groups, ethnic minority children and families in general face additional sociocultural stressors, such as discrimination, acculturation, cultural isolation, and poverty, that may increase their risk for developing psychopathology and reduce service use despite need (Chorpita et al 2002;Stormshak et al 2005). The combination of increased risk for psychopathology and less use of services produces a double burden for these families, as well as increased healthcare costs for communities and the country as a whole.…”

“…More than three decades later, the Surgeon General (2001) echoed the same concern, exposing racial and ethnic disparities as an unrelenting and unresolved challenge. Despite decades of attention to the issue, ethnic and racial minority children and families continue to be less likely to access mental health services than their mainstream counterparts (Wang et al 2005) and are more likely to delay seeking treatment and to drop out of treatment (Addis et al 1999;Chorpita et al 2002;Hoagwood et al 2010;. Contemporary thinkers have posited that racial and ethnic disparities in mental health services may result not only from logistical barriers, but also from the ubiquitous pressures of poverty and racism (Johnson et al 2000), stigma associated with receiving mental health care (McCabe 2002), and lack of knowledge about mental health .…”