Do empirically-supported packages or their practices predict superior therapy outcomes for youth with conduct problems?
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2011-08
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University of Hawaii at Manoa
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Treatment response for adolescents with conduct problems is often insufficient, while poor response is associated with a trajectory of negative long-term outcomes. The field has chiefly responded by disseminating and implementing empirically-supported treatment packages (ESTs). An alternative for furthering outcomes is the derived elements approach, which promotes therapist utilization of a high proportion of 'practices derived from ESTs' (PDEs). There has been little research to date demonstrating the real world outcomes of this approach. The primary aim of the present study was to conduct a head-to-head comparison of these dual approaches to delivering evidence-based services for adolescents with conduct problems. Under a rigorous propensity match protocol, this study examined whether level of PDE content or allocation to EST better predicted therapist-rated treatment goal progress in a sample of adolescents with conduct problems. A secondary aim was to investigate the extent to which PDE content mediated the relationship between the application of the EST (versus treatment as usual) and therapy progress. Provision of Multisystemic Therapy (MST), the selected EST package, and PDE content both predicted positive five month treatment outcomes with EST package predicting more variance in outcome. PDE content was a small partial mediator of the effect of treatment type on therapy progress. Results suggest future directions for research on PDEs, and provide further support for the derived elements approach as a complementary strategy to ESTs for bolstering treatment outcomes for this population.
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Multisystemic therapy
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Theses for the degree of Master of Arts (University of Hawaii at Manoa). Psychology.
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