The Clinic Treatment Project
Condition: Anxiety; Depression; Problem Behavior
MeSH terms: Depression; Problem Behavior
Study type: Interventional

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.
    

Intervention name(s): psychotherapy; evidence-based treatment; modular evidence-based treatment
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): Usual Care therapists could use any treatment procedures they used regularly in their clinical practice.; 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).; Therapists used the Modular Approach to Therapy for Children with Anxiety, Depression, or Conduct Problems (MATCH-ADC; Chorpita & Weisz, 2004)
Other intervention name(s): Treatment As Usual (TAU); Case Management; best practices; evidence-based practices; treatment manuals; modular treatments; best practices; evidence-based practices
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Outcomes Assessor)
Primary purpose: Treatment
Keywords: anxiety disorders; depression; depressive disorders; disruptive behavioral problems; conduct problems