Evidence-based (psychosocial) treatments (EBTs) for children's mental health problems have shown very beneficial effects in RCTs conducted under efficacy conditions;however, these EBTs, most of which focus on a single disorder or homogenous cluster, may face challenges when initially transported to everyday clinical care settings and used with referred children by practitioners who are learning to use EBTs for the first time. Working conditions of many practitioners limit the pace at which they can learn EBTs, particularly enough EBTs for their diverse caseloads. Child comorbidity plus flux in target problems during treatment may also complicate use of single-disorder EBTs by these practitioners. To address these and other challenges, we propose that single-disorder EBTs be complemented by a brief treatment protocol encompassing five basic skills that can be used to treat multiple child disorders involving anxiety, depression, and disruptive conduct, as a first step toward evidence-based practice for practitioners. This BASIC protocol integrates five treatment elements that (a) have been used in multiple EBTs for multiple disorders, and (b) have shown evidence of significant benefit even when used alone. The five skills are Belief Repair (identifying and modifying maladaptive cognitions), Action (behavioral activation/exposure to feared or challenging situations), Solving Problems (learning skills in systematic problem solving), Incentives (using reward and consequences to increase desired behaviors), and Calming (using relaxation skills to reduce distress, anxiety, or angry arousal). In three phases, the proposed project will include refining and testing BASIC and assessing readiness for a RCT. In Phase 1, the draft BASIC protocol will be completed, then refined via treatment expert and practitioner feedback plus field testing. Phase 2 will be a pilot open trial in which mental health clinic practitioners will use BASIC to treat community-referred 8-13 year-olds for anxiety-, depression-, and conduct-related disorders. Phase 3 will include data analysis, focused on clinical improvement, acceptability and feasibility of the BASIC protocol for consumers and clinicians, and readiness of BASIC for a RCT.

Public Health Relevance

A significant public health challenge for America is that about 20% of its children have a mental health disorder at any given time, and effective treatment for many is elusive. Clinical scientists have developed psychosocial treatments for these children, but some challenges remain for both the implementation and the effectiveness of these treatments in practice settings. This application is an effort to develop, refine, and begin testing an efficient, flexible, treatment protocol-called BASIC-that is designed to complement the single-disorder-focused evidence-based treatments that are so effective in specialized, intensive treatment of specific disorders. BASIC will serve as a kind of "first course" in evidence-based treatment for practitioners and thus as a bridge leading to the increased use of evidence-based practices in clinical care settings.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Planning Grant (R34)
Project #
5R34MH085963-03
Application #
8196998
Study Section
Interventions Committee for Disorders Involving Children and Their Families (ITVC)
Program Officer
Sherrill, Joel
Project Start
2009-12-01
Project End
2013-11-30
Budget Start
2011-12-01
Budget End
2013-11-30
Support Year
3
Fiscal Year
2012
Total Cost
$141,273
Indirect Cost
$42,273
Name
Judge Baker Children's Center
Department
Type
DUNS #
073824922
City
Boston
State
MA
Country
United States
Zip Code
02120
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Weisz, John R; Ugueto, Ana M; Herren, Jenny et al. (2011) Kernels vs. Ears, and Other Questions for a Science of Treatment Dissemination. Clin Psychol (New York) 18:41-46
Chorpita, Bruce F; Reise, Steven; Weisz, John R et al. (2010) Evaluation of the Brief Problem Checklist: child and caregiver interviews to measure clinical progress. J Consult Clin Psychol 78:526-36