FIRST: A Principal-Guided Approach to Evidence-Based Youth Psychotherapy

Note: The FIRST: A Principal-Guided Approach to Evidence-Based Youth Psychotherapy program was not responsive to the CEBC's inquiry. The following information was obtained from publicly available sources.

About This Program

Target Population: Not Specified

Program Overview

The FIRST program is a treatment approach which builds on five core principles found in evidence-based treatment for internalizing and externalizing problems in treatment of youth with anxiety, depression, and conduct problems. The five core principles included in the FIRST program are:

  • Feeling calm
  • Increasing motivation
  • Repairing thoughts
  • Solving problems
  • Trying the opposite

Logic Model

The program representative did not provide information about a Logic Model for FIRST: A Principal-Guided Approach to Evidence-Based Youth Psychotherapy.

Manuals and Training

Publicly available information indicates there is a manual that describes how to deliver this program.
See contact info below.

Relevant Published, Peer-Reviewed Research

Weisz, J., Bearman, S. K., Santucci, L. C., & Jensen-Doss, A. (2017). Initial test of a principle-guided approach to transdiagnostic psychotherapy with children and adolescents. Journal of Clinical Child & Adolescent Psychology, 46(1), 44–58.

Type of Study: One-group pretest–posttest
Number of Participants: 24 youth and parents, and 14 therapists


  • Age — Youth: 7–15 years (Mean=11.03 years), Parents: Not specified; Therapists: Mean=35.57 years
  • Race/Ethnicity — Youth: 87% White and 13% Latino, Parents: Not specified; Therapists: 93% Caucasian and 7% Latino
  • Gender — Youth: 50% Male, Parents: Not specified; Therapists: 79% Female
  • Status — Participants were youth who met full diagnostic criteria for one or more disorders within the anxiety, depression, or conduct-related clusters.

Location/Institution: Two urban community mental health clinics in the northeastern United States

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to address implementation challenges faced by some evidence-based youth psychotherapies. FIRST was developed as transdiagnostic approach—guided by five empirically supported principles of therapeutic change. Measures utilized include the Therapist Integrity in Evidence-Based Interventions (TIEBI), the Therapeutic Alliance Scale for Youths (TASC-C) and Parents (TASC-P), the Client Satisfaction Questionnaire (CSQ-8), the Therapist Satisfaction Inventory (TSI), the Brief Problem Checklist (BPC), the Top Problems Assessment (TPA), the Clinical Global Impression–Improvement (CGI) Scale, the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS), the Child Behavior Checklist (CBCL), the Youth Self Report (YSR), and the Services for Youths and Adolescents-Parent Interview (SCAPI). Results indicate weekly assessments throughout FIRST treatment showed effect sizes for clinical improvement ranging from 0.41 to 2.66 on weekly total problems and problems deemed “most important” by caregivers and youths. Limitations include small sample size, an open trial design, and diversity was limited.

Length of controlled postintervention follow-up: None.

Additional References

Kramer, U. (2009). Between manualized treatments and principle-guided psychotherapy: Illustration in the case of Caroline. Pragmatic Case Studies in Psychotherapy, 5(2), 45–51.

Marchette, L. K., & Weisz, J. R. (2017). Practitioner review: Empirical evolution of youth psychotherapy toward transdiagnostic approaches. Journal of Child Psychology and Psychiatry, 58(9), 970–984.

Weisz, J. R., & Bearman, S. K. (2020). Principle-guided psychotherapy for children and adolescents: The FIRST program for behavioral and emotional problems. Guilford Publications.

Contact Information

John R. Weisz, PhD, ABPP

Date Research Evidence Last Reviewed by CEBC: September 2021

Date Program Content Last Reviewed by Program Staff: December 2021

Date Program Originally Loaded onto CEBC: December 2021