Search Results

This chapter describes the third stage of evidence-based group work. It offers guidance and tools for critically evaluating the group-based evidence collected from the search completed in stage two. The chapter is divided into two sections. The first provides a discussion of the critical review system, which includes eight guides for evaluating evidence from quantitative (grouped and single-case designs) and qualitative studies, authorities, multiple studies/reports, literature reviews (systematic and non-systematic), and group-based measures. Each guide is divided into three areas in which group workers make an assessment, yielding an overall determination of the evidence's quality (yielding best available evidence). The first is the evidence's research merit, or its validity or rigor. The second is the evidence's impact; that is, how powerful and in what direction are the findings. The third is the evidence's applicability, its practice relevance and appropriateness. The second section of the chapter includes case examples illustrating how the guides are used.

This chapter continues the topic of ODD and CD, emphasizing its presentation and treatment in adolescence. It also focuses on substance use disorders given the shared risk factors for both ODD/CD and substance use disorders, and the fact that the disorders are often co-morbid. The chapter reviews the evidence basis for the treatment of these disorders in adolescence. Cognitive-behavioral individual approaches and multi-dimensional family theoretical approaches predominate in this literature. These interventions are evaluated against how well they address risk factors for the development of these disruptive behavior disorders and adjustment for afflicted youth. Recommendations for practice and research are explored.

This chapter explores the definition of evidence-based practice and lays out the frameworks that will be used to evaluate the research on child and adolescent treatment. These include the American Psychological Association Division 12 Task Force Criteria for empirically supported treatment and results of systematic reviews and meta-analyses. Additionally, evidence-based treatments in this book are assessed in terms of their ability to address the contextual variables influencing the development and the recovery from mental health diagnoses in youth, using risk and resilience as a framework. Case illustrations demonstrate the challenges of implementing evidence-based practice in real-world settings with youth from vulnerable populations, such as those living in poverty and from ethnic minority groups, and indicate the gaps in the literature, as well as the adaptations that may be considered.

EBP aims to integrate research and practice so that they are not parallel processes, but intimately integrated at every step. EBP is not to be confused with empirically-supported treatments or outcome evaluation. Both confuse the part for the whole. Evidenced-based practitioners use a practical process that places client's benefits as the highest priority. This process has five major stages: asking answerable questions, investigating the evidence efficiently and effectively, appraising the evidence, applying and adapting the evidence, and evaluating the results. There are two major caricatures of EBP that distort its definition. One of these is so flexible; it accepts virtually anything as evidence. The other is so rigid; it does not allow for any flexibility. This chapter argues for a middle path — one with high scientific standards as well as clinical sensitivity. It also addresses a common pitfall for each stage in the process.

Oppositional defiant disorder—characterized by anger and defiance—has a U.S. prevalence rate in youth of 10%, and 40% may go on to have more serious problems in terms of a diagnosis of Conduct Disorder. This chapter shows that the strongest evidence exists for parent training, with weaker support for individual and group cognitive-behavioral intervention. These interventions are evaluated against how well they address risk factors for the development of these disruptive behavior disorders and adjustment for an afflicted youth. Recommendations for practice and research are explored.

During the past decade and a half, increasing attention has been given to adapting empirically supported interventions for use with ethnic, cultural, and racial minority groups who were not part of the original intervention development process. The work of adapting has been intended to make interventions responsive and resonant to underrepresented groups, reflecting their cultural norms, values, beliefs, and parent practices. Among adaptation specialists, it has become axiomatic that the more attention given to the cultural adaptation of extant and new empirically supported treatments (ESTs), the closer interventions will approximate the characteristics of clients to be served. This chapter argues that one of the shortcomings in the cultural adaptation literature is the inattention to the multiple service contexts that influence the implementation of interventions, and the critical features that enhance the uptake of interventions and services: availability, accessibility, accommodation, affordability, and acceptability. The mismatch between interventions and the realities of service contexts is an oft-cited reason for the limited use of ESTs in practice. The literature on cultural adaptation indicates that shaping interventions to the needs of cultural groups increases their impact. The chapter addresses this issue, using parenting intervention with Hispanic families as a case in point.

In the U.S. the prevalence rate for the diagnosis of Attention-Deficit Hyperactivity Disorder (ADHD) in children and adolescents is nearly 8%, and worldwide rates are 5%. This chapter reviews the evidence basis for the treatment of ADHD. The evidence for treatment of ADHD mainly centers around medication (particularly the psychostimulants) and one type of psychosocial treatment: behavioral therapy. Controversy exists about which should be the first-line intervention. These interventions are also evaluated against how well they address risk factors for the development of ADHD and an afflicted youth's ongoing adjustment. Recommendations for future research are explored, such as establishing whether there are certain, discrete subpopulations of ADHD that warrant particular treatment approaches.