The lab versus the clinic. Effects of child and adolescent psychotherapy

Four recent meta-analyses, involving more than 200 controlled outcome studies, have shown consistent evidence of beneficial therapy effects with children and adolescents. However, most of the studies involved experimental procedures, nonreferred subjects, specially trained therapists with small caseloads, and other features that may not represent conventional clinic therapy. Research focused on more representative treatment of referred clients in clinics has shown more modest effects; in fact, most clinic studies have not shown significant effects. Interpretation studies have not shown significant effects. Interpretation of these findings requires caution; such studies are few and most could profit from improved methodology. The clinic studies do raise questions as to whether the positive lab findings can be generalized to the clinics where most therapy occurs; however, the lab interventions that have worked so well may point the way to enhanced therapy effects in clinics.