When the torch is passed, does the flame still burn? Testing a "train the supervisor" model for the Child STEPs...

Area of Science:

• Child and Adolescent Psychology
• Clinical Psychology
• Mental Health Services Research

Background:

• Empirically supported treatments (ESTs) are crucial for youth mental health.
• Transdiagnostic approaches offer efficient treatment for diverse youth mental health issues.
• Sustaining ESTs in community settings requires adaptable supervision models.

Purpose of the Study:

• To evaluate the sustainability of a transdiagnostic youth psychotherapy program (Child STEPs) when supervision transitions from external experts to internal clinic staff.
• To compare the effectiveness and fidelity of internal versus external supervision models for Child STEPs.

Main Methods:

• 168 youths (aged 6-15) with anxiety, depression, trauma, or conduct problems were treated.
• Phase 1 involved external supervision for the Sustain group.
• Phase 2 compared Sustain (internal supervision) with External Supervision groups, assessing therapist fidelity and clinical outcomes.

Main Results:

• Sustain clinicians maintained fidelity and youth outcomes after shifting to internal supervision.
• No significant differences in fidelity or outcomes were found between internal and external supervision groups in Phase 2.
• Trends suggested potentially better clinical outcomes with internal supervision.

Conclusions:

• Transdiagnostic treatment can be sustained by transferring supervision from external experts to trained internal staff.
• Internal supervision models may enhance the cost-effectiveness and long-term implementation of ESTs.
• This approach supports the integration of evidence-based practices in community mental health settings.