The Clinic Treatment Project

NCT ID: NCT01178554

Last Updated: 2011-03-16

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 203 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2005-06-30
• Study Completion Date: 2010-06-30

Brief Summary

The Clinic Treatment Project tested two alternative methods of delivering evidence-based practices within public community-based mental health clinics, using training and supervision procedures designed for the settings and users.

Detailed Description

The Clinic Treatment Project focused on ethnically diverse youths aged 7-13 who were referred to community-based mental health clinics for problems involving disruptive behaviors, depression, anxiety, and any combination of these. Using a randomized block design, therapists were randomly assigned to deliver usual treatment procedures (usual care, or UC) in their clinics or evidence-based practices deployed in two forms: (a) standard manual treatment (SMT), using full treatment manuals, one at a time, exactly as they have been tested in clinical trials, and (b) modular manual treatment (MMT) in which therapists learn the component practices of the standard manuals but individualize the use of the components for each child using a guiding clinical algorithm. Unlike the SMT approach, the MMT approach allows the duration and sequencing of techniques to be individualized in an effort to fit the child's needs and allows the clinician to draw techniques from outside the target disorder domain when needed (e.g., to address noncompliance during the course of treating depression). Both SMT and MMT were supported by training and supervision procedures designed to fit providers and their clinic contexts. Assessments were carried out at pre-treatment, at post-treatment, and at 3-, 6-, 9-, 12-, 18-, and 24-month follow-ups. Assessments carried out at pre-treatment included(a) individual youth problems and disorders; (b) individual youth functioning at home and school; and (c) clinic staff beliefs and attitudes toward their work and workplace. Assessments carried out at post-treatment and follow-up only included measures of (a) youth, parent, and therapist satisfaction with treatment; (b) youth, parent and therapist views on the quality of the therapeutic relationship; and (c) treatment costs. Assessments carried out at follow-up only included (a) parent reports of any mental health service use following project treatment, and (b) therapist reports on the extent to which the treatment procedures they used in the project are continued after project termination. Analyses will address critical questions about deployment of evidence-based youth practices to clinical care settings.

Conditions

Anxiety; Depression; Problem Behavior

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: TRIPLE

Study Groups

Usual Care Treatment

Usual Care therapists could use any treatment procedures they used regularly in their clinical practice.

Group Type: ACTIVE_COMPARATOR

psychotherapy

Intervention Type: BEHAVIORAL

Usual Care therapists could use any treatment procedures they used regularly in their clinical practice.

Standard Manual Treatment (SMT)

Evidence-based treatment manuals were used for anxiety (Coping Cat Manual; Kendall, 1994; Kendall et al., 1994 ), depression (Primary and Secondary Control Enhancement Training; Weisz et al., 1997, 1998), and conduct problems (Defiant Children Manual; Barkley, 1997).

Group Type: EXPERIMENTAL

evidence-based treatment

Intervention Type: BEHAVIORAL

Evidence-based treatment manuals were used for anxiety (Coping Cat Manual; Kendall, 1994; Kendall et al., 1994 ), depression (Primary and Secondary Control Enhancement Training; Weisz et al., 1997, 1998), and conduct problems (Defiant Children Manual; Barkley, 1997).

Modular Maual Treatment (MMT)

Therapists used a modular manual (Modular Approach to Therapy for Children with Anxiety, Depression, or Conduct Problems; Chorpita \& Weisz, 2004) to help children with primary problems of anxiety, depression, and conduct.

Group Type: EXPERIMENTAL

modular evidence-based treatment

Intervention Type: BEHAVIORAL

Therapists used the Modular Approach to Therapy for Children with Anxiety, Depression, or Conduct Problems (MATCH-ADC; Chorpita \& Weisz, 2004)

Interventions

psychotherapy

Usual Care therapists could use any treatment procedures they used regularly in their clinical practice.

Intervention Type: BEHAVIORAL

evidence-based treatment

Evidence-based treatment manuals were used for anxiety (Coping Cat Manual; Kendall, 1994; Kendall et al., 1994 ), depression (Primary and Secondary Control Enhancement Training; Weisz et al., 1997, 1998), and conduct problems (Defiant Children Manual; Barkley, 1997).

Intervention Type: BEHAVIORAL

modular evidence-based treatment

Therapists used the Modular Approach to Therapy for Children with Anxiety, Depression, or Conduct Problems (MATCH-ADC; Chorpita \& Weisz, 2004)

Intervention Type: BEHAVIORAL

Other Intervention Names

Treatment As Usual (TAU); Case Management; best practices; evidence-based practices; treatment manuals; modular treatments; best practices; evidence-based practices

Eligibility Criteria

Inclusion Criteria

• 7 - 13 year olds and their parents
• seeking services at community mental health clinics
• primary problem or disorder related to anxiety, depression, or conduct problems

Exclusion Criteria

• Child is younger than 7 years, 9 months or older than 13 on the day of the phone screen.
• Child has attempted suicide within the past year.
• Schizophrenic spectrum diagnosis (including MDD w/ psychotic features)
• Autism or another Pervasive Developmental Disorder (e.g., PDD NOS, Asperger's Disorder, Child Disintegrative Disorder, Rett's Disorder).
• Anorexia Nervosa
• Bulimia Nervosa
• Mental Retardation
• No relevant T-scores validate target disorders.
• ADHD identified as primary reason for seeking treatment at phone screen
• Child's sibling already included
• Child's medication has not been regulated for one month or longer

• Minimum Eligible Age: 7 Years
• Maximum Eligible Age: 13 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

MacArthur Foundation

OTHER

Sponsor Role: collaborator

University of Hawaii

OTHER

Sponsor Role: collaborator

University of Illinois at Chicago

OTHER

Sponsor Role: collaborator

Judge Baker Children's Center

OTHER

Sponsor Role: lead

Responsible Party

Judge Baker Children's Center

Principal Investigators

John R. Weisz, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

Judge Baker Children's Center

Bruce F. Chorpita, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

University of Hawaii

Locations

The University of Hawaii at Manoa

Honolulu, Hawaii, United States

Judge Baker Children's Center

Boston, Massachusetts, United States

Countries

United States

References

Chorpita BF, Bernstein A, Daleiden EL; Research Network on Youth Mental Health. Driving with roadmaps and dashboards: using information resources to structure the decision models in service organizations. Adm Policy Ment Health. 2008 Mar;35(1-2):114-23. doi: 10.1007/s10488-007-0151-x. Epub 2007 Nov 6.

Reference Type: BACKGROUND

PMID: 17987376 (View on PubMed)

Borntrager CF, Chorpita BF, Higa-McMillan C, Weisz JR. Provider attitudes toward evidence-based practices: are the concerns with the evidence or with the manuals? Psychiatr Serv. 2009 May;60(5):677-81. doi: 10.1176/ps.2009.60.5.677.

Reference Type: BACKGROUND

PMID: 19411357 (View on PubMed)

Ebesutani C, Bernstein A, Nakamura BJ, Chorpita BF, Higa-McMillan CK, Weisz JR; The Research Network on Youth Mental Health. Concurrent Validity of the Child Behavior Checklist DSM-Oriented Scales: Correspondence with DSM Diagnoses and Comparison to Syndrome Scales. J Psychopathol Behav Assess. 2010 Sep;32(3):373-384. doi: 10.1007/s10862-009-9174-9. Epub 2009 Nov 27.

Reference Type: BACKGROUND

PMID: 20700377 (View on PubMed)

Chorpita BF, Reise S, Weisz JR, Grubbs K, Becker KD, Krull JL; Research Network on Youth Mental Health. Evaluation of the Brief Problem Checklist: child and caregiver interviews to measure clinical progress. J Consult Clin Psychol. 2010 Aug;78(4):526-36. doi: 10.1037/a0019602.

Reference Type: BACKGROUND

PMID: 20658809 (View on PubMed)

Ebesutani C, Bernstein A, Nakamura BJ, Chorpita BF, Weisz JR; Research Network on Youth Mental Health. A psychometric analysis of the revised child anxiety and depression scale--parent version in a clinical sample. J Abnorm Child Psychol. 2010 Feb;38(2):249-60. doi: 10.1007/s10802-009-9363-8.

Reference Type: BACKGROUND

PMID: 19830545 (View on PubMed)

Ho A, Weisz JR, Austin AA, Chorpita BF, Southam-Gerow M, Wells K, the Research Network on Youth Mental Health. Bridging science and community practice: Clinician and organizational engagement in community clinics in the clinic treatment project. Emotional and Behavioral Disorders in Youth. Winter 2006;7:13-19.

Reference Type: BACKGROUND

Martin JL, Weisz JR, Chorpita BF, Higa CK, Southam-Gerow M, Wells K, the Research Network on Youth Mental Health. Moving evidence-based practices into everyday clinical care settings: Addressing challenges associated with pathways to treatment, child characteristics, and structure of treatment. Emotional and Behavioral Disorders in Youth. Winter 2006;7:5-21.

Reference Type: BACKGROUND

Palinkas LA, Aarons GA, Chorpita BF, Hoagwood K, Landsverk J, Weisz JR; Research Network on Youth Mental Health. Cultural exchange and the implementation of evidence-based practice: two case studies. J Evidence-Based Social Work. 2009 September;19(5):602-612.

Reference Type: BACKGROUND

Palinkas LA, Schoenwald SK, Hoagwood K, Landsverk J, Chorpita BF, Weisz JR; Research Network on Youth Mental Health. An ethnographic study of implementation of evidence-based treatments in child mental health: first steps. Psychiatr Serv. 2008 Jul;59(7):738-46. doi: 10.1176/ps.2008.59.7.738.

Reference Type: BACKGROUND

PMID: 18586990 (View on PubMed)

Weisz JR, Chorpita BF, Palinkas LA, Schoenwald SK, Miranda J, Bearman SK, Daleiden EL, Ugueto AM, Ho A, Martin J, Gray J, Alleyne A, Langer DA, Southam-Gerow MA, Gibbons RD; Research Network on Youth Mental Health. Testing standard and modular designs for psychotherapy treating depression, anxiety, and conduct problems in youth: a randomized effectiveness trial. Arch Gen Psychiatry. 2012 Mar;69(3):274-82. doi: 10.1001/archgenpsychiatry.2011.147. Epub 2011 Nov 7.

Reference Type: DERIVED

PMID: 22065252 (View on PubMed)

Related Links

http://www.child-steps.org/

Child System and Treatment Enhancement Projects

Other Identifiers

83423-0

Identifier Type: -

Identifier Source: org_study_id