Building Robust Psychotherapies for Children and Adolescents

Psychotherapies for children and adolescents have been tested in hundreds of randomized controlled trials across five decades, and many of these youth therapies have now been classified as empirically supported treatments (ESTs). A burgeoning movement is underway to implement these ESTs in clinical practice settings, but questions arise as to whether the treatments are ready for practice and whether they will improve outcomes for clinically referred youths. Our data show ESTs to be more effective than usual care, on average, but only modestly so, and there are troubling exceptions. One reason may be that the design of most ESTs (e.g., single-disorder focus, linear session sequence) does not fit the characteristics of referred youths or clinical practice very well. Indeed, youth psychotherapy research has not focused much on the clients or contexts of actual clinical care. An alternative empirical approach, the deployment-focused model, proposes developing and testing interventions with the clients, clinicians, and contexts for which they are ultimately intended. Recent application of the model highlights its potential for stimulating robust treatments that are effective in clinical practice.