Long-Term Outcomes for the Child STEPs Randomized Effectiveness Trial: A Comparison of Modular and Standard Treatment Designs With Usual Care

• Published in: Journal of consulting and clinical psychology Vol. 81; no. 6; pp. 999 - 1009
• Main Authors: Chorpita, Bruce F., Weisz, John R., Daleiden, Eric L., Schoenwald, Sonja K., Palinkas, Lawrence A., Miranda, Jeanne, Higa-McMillan, Charmaine K., Nakamura, Brad J., Austin, A. Aukahi, Borntrager, Cameo F., Ward, Alyssa, Wells, Karen C., Gibbons, Robert D.
• Format: Journal Article
• Language: English
• Published: Washington, DC American Psychological Association 01-12-2013
• Subjects: Adolescent; Adult and adolescent clinical studies; Algorithms; Anxiety; Anxiety Disorders; Anxiety Disorders - diagnosis; Anxiety Disorders - psychology; Anxiety Disorders - therapy; Anxiety-Depression; Attention Deficit and Disruptive Behavior Disorders - diagnosis; Attention Deficit and Disruptive Behavior Disorders - psychology; Attention Deficit and Disruptive Behavior Disorders - therapy; Behavior; Behavior Problems; Behavior Therapy - methods; Biological and medical sciences; Child; Children; Clinical standards; Comparative analysis; Conduct Disorder; Depression; Depressive Disorder - diagnosis; Depressive Disorder - psychology; Depressive Disorder - therapy; Evidence-Based Practice; Female; Follow-Up Studies; Hawaii; Human; Humans; Long Term Care; Long term effects; Major Depression; Male; Medical sciences; Mental depression; Mental health care; Miscellaneous; Mood disorders; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Selfreport; Treatment Effectiveness Evaluation; Treatment Outcomes; Young people; Hawaii; modular treatment; anxiety; conduct problems; depression; randomized effectiveness trial; Human; Mood disorder; Affect affectivity; Conduct disorder; Depression; Long term; Care; Treatment; Evolution; Anxiety; Social behavior disorder; Child; Comparative study
• ISSN: 0022-006X; 1939-2117
• DOI: 10.1037/a0034200

Objective: This article reports outcomes from the Child STEPs randomized effectiveness trial conducted over a 2-year period to gauge the longer term impact of protocol design on the effectiveness of evidence-based treatment procedures. Method: An ethnoracially diverse sample of 174 youths ages 7- 13 (N = 121 boys) whose primary clinical concerns involved diagnoses or clinical elevations related to anxiety, depression, or disruptive behavior were treated by community therapists randomly assigned to 1 of 3 conditions: (a) standard, which involved the use of 1 or more of 3 manualized evidence-based treatments, (b) modular, which involved a single modular protocol (Modular Approach to Treatment of Children With Anxiety, Depression, or Conduct Problems; MATCH) having clinical procedures similar to the standard condition but flexibly selected and sequenced using a guiding clinical algorithm, and (c) usual care. Results: As measured with combined Child Behavior Checklist and Youth Self-Report Total Problems, Internalizing, and Externalizing scales, the rate of improvement for youths in the modular condition was significantly better than for those in usual care. On a measure of functional impairment (Brief Impairment Scale), no significant differences were found among the 3 conditions. Analysis of service utilization also showed no significant differences among conditions, with almost half of youths receiving some additional services in the 1st year after beginning treatment, and roughly one third of youths in the 2nd year. Conclusions: Overall, these results extend prior findings, supporting incremental benefits of MATCH over usual care over a 2-year period.