Much of our current research and theory on child and adolescent mental health services and their outcomes is derived from controlled experiments, in which conditions may not fully represent services in clinics. To address this limitation, the project will focus on actual clinic treatment of children and adolescents (here, """"""""children"""""""") from three socioculturally diverse clinic settings employing 60 child therapists. 900 children, aged 8-15, will be assessed at the time of intake, with a combination of established clinical measures (e.g., diagnosis, problem behavior) and recently-developed, psychometrically sound measures of adjustment, cognition, and parent-child interaction. The measures will be repeated at 6 months, 1 year, and 2 years after intake, both for children who complete a course of therapy and those who drop out at intake. The resulting longitudinal data will be used to address two primary questions of theoretical and practical import, both growing out of earlier findings by the PI and colleagues: 1. Among youngsters referred for outpatient care, who stays for treatment and who drops out? Previous findings (e.g., Weisz, Weiss, & Langmeyer, 1987, 1989) may be questioned because no research has yet distinguished between three rather different forms of """"""""dropping out."""""""" The proposed project will do so; more definitive findings may result. 2. For youngsters who stay in treatment, does clinic-based therapy have beneficial effects? Although meta-analyses of controlled outcome studies (e.g., Weisz, Weiss, Alicke, & Klotz, 1987) suggest that the answer is yes; but a recent study of clinic-based child therapy (Weisz & Weiss, in press a) showed no therapy effect. Perhaps clinic-based therapy is less than optimum in its procedures and results; or perhaps the null findings of Weisz and Weiss (in press a) resulted from methodological limitations. To find out, the project will address those limitations and assess a broadened array of outcomes. Regardless of whether these analyses reveal overall effects of therapy, secondary analyses will follow up on previous findings (e.g., Poal & Weisz, in press; Weisz, 1986a) suggesting that child, family, therapist, or therapy factors may predict improvement. An immediate objective is to test specific theoretically- and empirically-derived hypotheses about child mental health care and its effects. A broad, long-term objective (of the project and the research program of which it is a part) is to complement our field's growing base of controlled experimental evidence with rigorous information on the process and outcomes of child mental health care in practicing clinics.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH049522-02
Application #
2248936
Study Section
Epidemiologic and Services Research Review Committee (EPS)
Project Start
1991-09-30
Project End
1994-08-31
Budget Start
1992-09-30
Budget End
1994-08-31
Support Year
2
Fiscal Year
1992
Total Cost
Indirect Cost
Name
University of California Los Angeles
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
119132785
City
Los Angeles
State
CA
Country
United States
Zip Code
90095
Langer, David A; McLeod, Bryce D; Weisz, John R (2011) Do treatment manuals undermine youth-therapist alliance in community clinical practice? J Consult Clin Psychol 79:427-32
McLeod, Bryce D; Weisz, John R (2010) The Therapy Process Observational Coding System for Child Psychotherapy-Strategies Scale. J Clin Child Adolesc Psychol 39:436-43
Jensen-Doss, Amanda; Weisz, John R (2008) Diagnostic agreement predicts treatment process and outcomes in youth mental health clinics. J Consult Clin Psychol 76:711-22
McLeod, Bryce D; Wood, Jeffrey J; Weisz, John R (2007) Examining the association between parenting and childhood anxiety: a meta-analysis. Clin Psychol Rev 27:155-72
Lau, Anna S; Valeri, Sylvia M; McCarty, Carolyn A et al. (2006) Abusive parents' reports of child behavior problems: relationship to observed parent-child interactions. Child Abuse Negl 30:639-55
Doss, Amanda Jensen; Weisz, John R (2006) Syndrome co-occurrence and treatment outcomes in youth mental health clinics. J Consult Clin Psychol 74:416-25
Weisz, John R; Weiss, Bahr; Suwanlert, Somsong et al. (2006) Culture and youth psychopathology: testing the syndromal sensitivity model in Thai and American adolescents. J Consult Clin Psychol 74:1098-107
Hawley, Kristin M; Weisz, John R (2005) Youth versus parent working alliance in usual clinical care: distinctive associations with retention, satisfaction, and treatment outcome. J Clin Child Adolesc Psychol 34:117-28
McLeod, Bryce D; Weisz, John R (2005) The therapy process observational coding system-alliance scale: measure characteristics and prediction of outcome in usual clinical practice. J Consult Clin Psychol 73:323-33
McCarty, Carolyn A; Lau, Anna S; Valeri, Sylvia M et al. (2004) Parent-child interactions in relation to critical and emotionally overinvolved expressed emotion (EE): is EE a proxy for behavior? J Abnorm Child Psychol 32:83-93

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