Child mental health issues best dealt with using research-supported treatments

Various therapy options have been developed over the years to aid children with severe emotional and behavioral problems. Advocates of evidence-based treatments, despite doubts and criticisms, have lobbied for more widespread use of research-supported therapies. A new study by researchers from Harvard University-affiliated Judge Baker Children's Center, Texas A&M University and the University of Missouri-Columbia supports their case, as research-supported or evidence-based treatments were significantly more effective than standard or usual care in helping children overcome mental health issues.

Evidence-based treatments are those supported by randomized clinical trials at universities and clinics. They typically involve the use of a therapy manual and offer treatments such as timeout, rewards for good behavior, cognitive restructuring or problem-solving skills to children. Standard or usual care sometimes includes research-based methods, but rarely includes using a therapy manual. In this review, standard or usual care included counseling and case management administered by clinics, hospitals, juvenile justice departments and community agencies.

"Across the existing studies that compared evidence-based interventions with standard care, children treated with one of these evidence-based interventions were, on average, better off than 62 percent of those treated with standard or usual care therapy," said Kristin Hawley, assistant professor of Psychological Sciences. "That means evidence-based care outperformed the current standard of care in this review."

Hawley collaborated with John Weisz, professor of psychology at Harvard Medical School and president and CEO of Judge Baker Children's Center, and Amanda Jensen Doss, assistant professor of educational and clinical psychology at Texas A&M. They reviewed 32 clinical trials conducted over a 40-year period. The majority dealt with child and adolescent conduct problems. The other studies dealt with depression and anxiety. The studies compared the mental health status of children who received each form of therapy. Evidence-based treatments outperformed standard care as children experienced a greater decrease in behavioral problems, depression or anxiety when treated using research-supported therapies, Hawley said.

She said the 32 studies represent only a small microcosm of clinical trials conducted over the years to develop and test evidence-based treatments. Hawley said traditionally the effectiveness of evidence-based treatments has been determined by comparing the well-being of children receiving psychotherapy versus nothing at all, or versus extra adult attention and support.

Hawley said the direct comparison with standard or usual care is a rarity and additional studies are needed "to maximize the quality of care that children and their families receive."

The study "Evidence-Based Youth Psychotherapies versus Usual Clinical Care: A Meta-Analysis of Direct Comparisons" appears in the October 2006 issue of American Psychologist.

Links:

Kristin Hawley
Department of Psychological Sciences

John Weisz, Judge Baker Children's Center, Harvard University
Amanda Jensen Doss, Texas A&M University


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