Handbook of Interventions that Work with Children and Adolescents: Prevention and Treatment / Edition 1 available in Hardcover
Handbook of Interventions that Work with Children and Adolescents: Prevention and Treatment / Edition 1
- ISBN-10:
- 0470844531
- ISBN-13:
- 9780470844533
- Pub. Date:
- 12/02/2003
- Publisher:
- Wiley
Handbook of Interventions that Work with Children and Adolescents: Prevention and Treatment / Edition 1
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Overview
Arranged in three parts, Part I lays theoretical foundations of “treatments that work” with children and adolescents. Part II presents the evidence base for the treatment of a host of behaviour problems, whilst Part III contains exciting prevention programs that attempt to intervene with several child and adolescent problems before they become disorders.
This Handbook presents encouraging evidence that we can intervene successfully at the psychosocial level with children and adolescents who already have major psychiatric disorders and, as importantly, that we can even prevent some of these disorders from occurring in the first place.
Product Details
| ISBN-13: | 9780470844533 |
|---|---|
| Publisher: | Wiley |
| Publication date: | 12/02/2003 |
| Pages: | 576 |
| Product dimensions: | 6.85(w) x 9.84(h) x 1.49(d) |
About the Author
Thomas H. Ollendick is University Distinguished Professor in Clinical Psychology and Director of the Child Study Center at Virginia Polytechnic Institute and State University, Blacksburg, Virginia. He is the author or co-author of over 300 research publications, 75 book chapters, and 25 books.
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Handbook of Interventions that Work with Children and Adolescents
Prevention and TreatmentJohn Wiley & Sons
Copyright © 2004 John Wiley & Sons, Ltd.All right reserved.
ISBN: 0-470-84453-1
Chapter One
Empirically Supported Treatments for Children and Adolescents: Advances Toward Evidence-Based PracticeThomas H. Ollendick
Virginia Polytechnic Institute and State University, USA
and
Neville J. King
Monash University, Australia
INTRODUCTION
About 50 years ago, Eysenck (1952) published his now (in)famous review of the effects of adult psychotherapy. Boldly, he concluded that psychotherapy practices in vogue at that time were no more effective than the simple passage of time. Subsequently, Levitt (1957, 1963) reviewed the child psychotherapy literature and arrived at a similar conclusion. These reviews were both contentious and provocative, leading many to question the continued viability of the psychotherapy enterprise for both adults and children.
Fortunately, as noted by Kazdin (2000), these reviews also served as a wake-up call and led to a host of developments including advances in child psychopathology, psychiatric diagnostic nomenclature, assessment and treatment practices, and experimental designs for the study of treatment process and outcome. These developments, in turn, resulted in well over 1500 studies (Durlak et al., 1995; Kazdin, 2000) and fourmajor meta-analyses examining the effects of child psychotherapy (Casey & Berman, 1985; Kazdin et al., 1990; Weisz et al., 1987, 1995). As noted recently by Weersing and Weisz (2002), there is now little doubt that at present child psychotherapy results in beneficial impacts on the lives of children and their families. Consistently, these reviews demonstrate that therapy for children outperforms waiting list and attention-placebo conditions; moreover, in several studies, it is becoming clear that some forms of therapy work better than others. As a result, much progress has been made and we can conclude that the field of clinical child psychology has moved beyond the simple question, "Does psychotherapy work for children?" to identify the efficacy of specific treatments for children who present with specific behavioural, emotional, and social problems. Basically, then, the field has moved from the generic question of whether psychotherapy "works" at all for children to a more specific one that seeks to determine the evidence base for these various treatments and the conditions under which they are effective. This is an exciting time in the field of child psychotherapy research, and the various chapters in this volume attest to what we know and what we do not know in treating various childhood problems and disorders.
This chapter describes some of the early work undertaken to identify empirically supported psychosocial treatments for children and raises some critical issues attendant to this movement. First, it should be acknowledged that this movement is part of a larger zeitgeist labelled "evidence-based medicine" (Sackett et al., 1997, 2000), which we refer to here as "evidence-based practice". Evidence-based practice is at its core an approach to knowledge and a strategy for improving performance outcomes (Alvarez & Ollendick, 2003). It is not wedded to any one theoretical position or orientation. It holds that treatments of whatever theoretical persuasion need to be based on objective and scientifically credible evidence-evidence that is obtained from randomized clinical trials (RCTs), whenever possible. In a RCT, children with a specific presenting problem are randomly assigned to one treatment or another or to some control condition, such as a waiting list or attention-placebo condition. Although such a design is not failsafe, it appears to be the best strategy for ruling out biases and expectations (on the part of both the child and the therapist) that can result in misleading research findings. By its nature, evidence-based practice values information or opinions obtained from observational studies, logical intuition, personal experiences, and the testimony of experts less highly. Such evidence is not necessarily "bad" or "undesired", it is just less credible and acceptable from a scientific, evidentiary-based standpoint. And, it simply occupies a lower rung on the evidentiary ladder of evidence.
The movement to develop, identify, disseminate, and use empirically supported psychosocial treatments (initially referred to as empirically "validated" treatments; see Chambless, 1996, and Chambless & Hollon, 1998) has been controversial. On the surface, it hardly seemed possible that anyone could or would object to the initial report issued by the Society of Clinical Psychology (Division 12) of the American Psychological Association in 1995 or that the movement associated with it would become so controversial. Surely, identifying, developing, and disseminating treatments that have empirical support should be encouraged, not discouraged, especially for a profession that is committed to the welfare of those whom it serves.
Sensible as this may seem, the task force report was not only controversial, but it also, unfortunately, served to divide the profession of clinical psychology and related mental health disciplines (Ollendick & King, 2000). In this chapter, we first define empirically supported treatments and then briefly examine the current status of such treatments. In doing so, we illustrate the potential value of these treatments. Other chapters in this volume provide in-depth detail on the efficacy of these treatments for specific problems and disorders. Next, we illustrate and discuss some of the contentious issues associated with these treatments and their development and promulgation. We conclude our discourse by offering recommendations for future research and practice.
ON THE NATURE OF EMPIRICALLY SUPPORTED TREATMENTS
In 1995, as noted earlier, the Society of Clinical Psychology Task Force on Promotion and Dissemination of Psychological Procedures published its report on empirically validated psychological treatments. The task force was constituted of members who represented a number of theoretical perspectives, including psychodynamic, interpersonal, and cognitive-behavioural points of view. This diversity in membership was an intentional step taken by the committee to emphasize a commitment to identifying and promulgating all psychotherapies of proven worth, not just those emanating from one particular school of thought. Defining empirically validated treatments proved to be a difficult task, however. Of course, from a scientific standpoint no treatment is ever fully validated and, as noted in the task force report, there are always more questions to ask about any treatment, including questions about the essential components of treatments, client characteristics that predict treatment outcome, and the mechanisms or processes associated with behaviour change. In recognition of this state of affairs, the term empirically supported was adopted subsequently to describe treatments of scientific value-a term that many agreed was more felicitous than empirically validated.
Three categories of treatment efficacy were proposed in the 1995 report: (1) well-established treatments, (2) probably efficacious treatments, and (3) experimental treatments (see Table 1.1). The primary distinction between well-established and probably efficacious treatments was that a well-established treatment should have been shown to be superior to a psychological placebo, pill, or another treatment whereas a probably efficacious treatment should be shown to be superior to a waiting list or no treatment control only. In addition, effects supporting a well-established treatment should be demonstrated by at least two different investigatory teams, whereas the effects of a probably efficacious treatment need not be (the effects might be demonstrated in two studies from the same investigator, for example). For both types of empirically supported treatments, characteristics of the clients should be clearly specified (e.g., age, sex, ethnicity, diagnosis) and the clinical trials should be conducted with treatment manuals. Furthermore, it was required that these outcomes be demonstrated in "good" group design studies or a series of controlled single case design studies. "Good" designs were those in which it was reasonable to conclude that the benefits observed were due to the effects of treatment and not due to chance or confounding factors such as passage of time, the effects of psychological assessment, or the presence of different types of clients in the various treatment conditions (Chambless & Hollon, 1998; also see Kazdin, 1998, and Kendall, Flannery-Schroeder, & Ford, 1999, for a fuller discussion of research design issues). Ideally, and as noted earlier, treatment efficacy should be demonstrated in randomized clinical trials (RCTs)-group designs in which patients would be assigned randomly to the treatment of interest or one or more comparison conditions-or carefully controlled single case experiments and their group analogues. Finally, experimental treatments were those treatments not yet shown to be at least probably efficacious. This category was intended to capture long-standing or traditional treatments that had not yet been fully evaluated or newly developed ones not yet put to the test of scientific scrutiny. The development of new treatments was particularly encouraged. It was also noted that treatments could "move" from one category to another dependent on the empirical support available for that treatment over time. That is, an experimental procedure might move into probably efficacious or well-established status as new findings became available. The categorical system was intended to be fluid, not static.
EMPIRICALLY SUPPORTED PSYCHOSOCIAL TREATMENTS FOR CHILD BEHAVIOUR PROBLEMS AND DISORDERS
The 1995 Task Force Report on Promotion and Dissemination of Psychological Procedures identified 18 well-established treatments and 7 probably efficacious treatments, using the criteria described above and presented in Table 1.1. Of these 25 efficacious treatments, only three well-established treatments for children (behaviour modification for developmentally disabled individuals, behaviour modification for enuresis and encopresis, and parent training programs for children with oppositional behaviour) and one probably efficacious treatment for children (habit reversal and control techniques for children with tics and related disorders) were identified. As noted in that report, the list of empirically supported treatments was intended to be representative of efficacious treatments, not exhaustive. In recognition of the need to identify additional psychosocial treatments that were effective with children, concurrent task forces were set up by the Society of Clinical Psychology and its offspring, the Society of Clinical Child and Adolescent Psychology (Division 53 of the American Psychological Association). The two independent task forces joined efforts and in 1998 published their collective reviews in the Journal of Clinical Child Psychology. Reviews of empirically supported treatments for children with autism, anxiety disorders, attention deficit hyperactivity disorder (ADHD), depression, and oppositional and conduct problem disorders were included in the special issue. As noted by Lonigan, Elbert, and Johnson (1998), the goal was not to generate an exhaustive list of treatments that met criteria for empirically supported treatments; rather, the goal was to focus on a number of high-frequency problems encountered in clinical and other settings serving children with mental health problems. As such, a number of problem areas were not reviewed (e.g., eating disorders, childhood schizophrenia), and the identification of empirically supported treatments for these other problem areas remains to be accomplished, even to this day. Overall, the goal was to identify effective psychosocial treatments for a limited number of frequently occurring disorders in childhood.
In a recent review of empirically supported psychological interventions for adults and children published in the Annual Review of Psychology, Chambless and Ollendick (2001) noted that other ventures have also been instrumental in identifying empirically supported treatments for children and adults. Namely, edited books by Roth et al. (1996, What works for Whom?) and Nathan and Gorman (1998, A Guide to Treatments that Work) have identified other treatments and evaluated many of the same ones identified by the Society of Clinical Psychology and the Society of Clinical Child and Adolescent Psychology. In general, the criteria used by the various groups have been similar, although some relatively minor differences are evident (see Chambless & Ollendick, 2001, for details). In Table 1.2, we present a summary of interventions for children with various problems and disorders found to be empirically supported by at least one of these four review groups. In many, if not most, instances the same treatments were identified as effective by two or more of these groups.
As shown in Table 1.2, it is evident that many well-established and probably efficacious treatments have been identified. Yet, we must be somewhat modest, inasmuch as no well-established treatments have been identified for the treatment of such common problems as autism, childhood depression, or childhood anxiety. Although a host of interventions appear promising and can be described as probably efficacious, it is evident that support for them is relatively meagre. Rarely did any one treatment have more than the two requisite studies to support its well-established or probably efficacious status (with the exception of parenting programs for oppositional and conduct problem children and for children with ADHD). It should also be evident that all of these probably efficacious and well-established treatments are based on behavioural and cognitive-behavioural principles. As a result, using these criteria, we do not really know whether frequently practiced treatments from other orientations work or not (e.g., play therapy, interpersonal psychotherapy); in many instances, they simply have not been evaluated sufficiently. Still, the value of identifying and promulgating treatments that do have support for their use is apparent.
Continues...
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Table of Contents
About the Editors.List of Contributors.
Preface.
Acknowledgments.
PART I: CONTEMPORARY ISSUES RELATED TO COMPETENT CLINICAL AND RESEARCH PRACTICE.
Chapter 1: Empirically Supported Treatments for Children and Adolescents: Advances Toward Evidence-Based Practice (Thomas H. Ollendick and Neville J. King).
Chapter 2: Developmental Issues in Evidence-Based Practice (Grayson N. Holmbeck, Rachel Neff Greenley, and Elizabeth A. Franks).
Chapter 3: Assessment and Diagnosis in Evidence-Based Practice (Wendy K. Silverman and Lissette M. Saavedra).
Chapter 4: Evaluation Issues in Evidence-Based Practice (Nirbhay N. Singh and Donald P. Oswald).
Chapter 5: Assessment and Treatment of Ethnically Diverse Children and Adolescents (Robi Sonderegger and Paula M. Barrett).
PART II: TREATMENT STATUS FOR SPECIFIC EMOTIONAL AND BEHAVIOURAL DISORDERS.
Chapter 6: Treatment of Generalized Anxiety Disorder in Children and Adolescents (Jennifer L. Hudson, Alicia A. Hughes, and Philip C. Kendall).
Chapter 7: Treatment of SAD and Panic Disorder in Children and Adolescents (Sara G. Mattis and Donna B. Pincus).
Chapter 8: Treatment of Social Phobia in Children and Adolescents (Tracy L. Morris).
Chapter 9: Obsessive-Compulsive Disorder in Childhood and Adolescence: Description and Treatment (Paula M. Barrett, Lara Healy-Farrell, John Piacentini, and John March).
Chapter 10: Treatment of PTSD in Children and Adolescents (Sean Perrin, Patrick Smith, and William Yule).
Chapter 11: Treatment of School Refusal (David Heyne and Neville J. King).
Chapter 12: Treatment of Specific Phobia in Children and Adolescents (Thomas H. Ollendick, Thompson E. Davis III, and Peter Muris).
Chapter 13: Treatment of Depression in Children and Adolescents (Laura D. Seligman, Amanda B. Goza, and Thomas H. Ollendick).
Chapter 14: Treatment of Substance Abuse Disorders in Children and Adolescents (Holly Barrett Waldron and Sheryl Kern-Jones).
Chapter 15: Treatment of ADHD in Children and Adolescents (Karen C.Wells).
Chapter 16: Treatment of Oppositional Defiant Disorder in Children and Adolescents (Ross W. Greene, J. Stuart Ablon, Jennifer C. Goring, Vanessa Fazio, and Lauren R. Morse).
Chapter 17: Treatment of Conduct Problems in Children and Adolescents (Robert J. McMahon and Julie S. Kotler).
PART III: PREVENTION INITIATIVES FOR SPECIFIC EMOTIONAL AND BEHAVIOURAL DISORDERS.
Chapter 18: Prevention of Childhood Anxiety and Depression (Paula M. Barrett and Cynthia M. Turner).
Chapter 19: Prevention of Oppositional Defiant Disorder and Conduct Disorder in Children and Adolescents (Ronald J. Prinz and Jean E. Dumas).
Chapter 20: Using the Triple P System of Intervention to Prevent Behavioural Problems in Children and Adolescents (Matthew R. Sanders, Carol Markie-Dadds, Karen M.T. Turner, and Alan Ralph).
Chapter 21: Prevention of Substance Abuse in Children and Adolescents (Cecilia A. Essau).
Index.