Weisz, J. R., Chorpita, B. F., Palinkas, L. A., Schoenwald, S. K., Miranda, J., Bearman, S. K., Daleiden, E. L., Ugueto, A. M., Ho, A., Martin, J., Gray, J., Alleyne, A., Langer, D. A., Southam-Gerow, M. A., Gibbons, R. D., & Research Network on Youth Men Testing standard and modular designs for psychotherapy with youth depression, anxiety, and conduct problems: A randomized effectiveness trial. Archives of General Psychiatry, 69(3), 274–282. https://doi.org/10.1001/archgenpsychiatry.2011.147

Type of Study: Randomized controlled trial
Number of Participants: 174

Population:

• Age — 7-13 years (Mean=10.59 years)
• Race/Ethnicity — 45% White, 32% Multiethnic, 9% African American, 6% Latino/Latina, 4% Asian American/Pacific Islander, 2% other, and 2% did not choose to classify
• Gender — 70% Male
• Status — Participants were youth that sought outpatient care and had primary disorders or referral problems involving anxiety, depression, or disruptive conduct.

Location/Institution: Ten outpatient clinical service organizations in Massachusetts and Hawaii

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to compare standard/separate and modular/integrated arrangements of evidence-based treatments for depression, anxiety, and conduct problems in youth with usual care (UC). Practitioners were randomly assigned to 3 treatment conditions: modular (now called Modular Approach to Therapy for Children with Anxiety, Depression, Trauma, or Conduct Problems [MATCH-ADTC]), standard (i.e., the use of 3 established EBTs for anxiety, depression, and conduct problems), or usual care. Measures utilized include the Brief Problem Checklist (BPC), the Top Problems Assessment (TPA), the Children’s Interview for Psychiatric Syndromes, and the Services for Children and Adolescents–Parent Interview. Results indicate MATCH-ADTC produced significantly steeper trajectories of improvement than usual care and standard treatment on multiple Brief Problem Checklist and Top Problems Assessment measures. Youths receiving MATCH-ADTC treatment also had significantly fewer diagnoses than youths receiving usual care after treatment. In contrast, outcomes of standard manual treatment did not differ significantly from outcomes of usual care. Limitations include constraints on the level of analysis imposed by sample size, only those who sought treatment on their own were included, and lack of follow-up.

Length of controlled postintervention follow-up: None.

Chorpita, B. F., Weisz, J. R., Daleiden, E. L., Schoenwald, S. K., Palinkas, L. A., Miranda, J., Higa-McMillan, C. K., Nakamura, B. J., Austin, A. A., Borntrager, C. F., Ward, A., Wells, K. C., Gibbons, R. D., & Research Network on Youth Mental Health (20 Long-term outcomes for the Child STEPs randomized effectiveness trial: A comparison of modular and standard treatment designs with usual care. Journal of Consulting and Clinical Psychology, 81(6), 999–1009. https://doi.org/10.1037/a0034200

Type of Study: Randomized controlled trial
Number of Participants: 174

Population:

• Age — 7-13 years
• Race/Ethnicity — 45% White, 32% multiethnic, 9% African American, 6% Latino/Latina, 4% Asian American/Pacific Islander, and 2% other
• Gender — 70% Male
• Status — Participants were children whose primary clinical concerns involved diagnoses or clinical elevations related to anxiety, depression, or disruptive behavior.

Location/Institution: Ten different outpatient community and school-based settings in Massachusetts and Hawaii

Summary: (To include basic study design, measures, results, and notable limitations)
This study used the sample from Weisz et al. (2012). The purpose of the study was to report outcomes from the Child STEPs trial to gauge the longer-term impact of protocol design on the effectiveness of evidence-based treatment procedures. Community therapists were 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 Therapy for Children [MATCH] – [now called Modular Approach to Therapy for Children with Anxiety, Depression, Trauma, or Conduct Problems [MATCH-ADTC]), and (c) usual care. Measures utilized include the Child Behavior Checklist for Ages 6–18 (CBCL), the Youth Self-Report for Ages 11–18 (YSR), the Brief Impairment Scale (BIS), the Children’s Interview for Psychiatric Syndromes, and the Services Assessment for Children and Adolescents–Brief Parent Version (SACA). Results indicate that the rate of improvement for youth in the MATCH condition was significantly better than those in usual care. On a measure of functional impairment, no significant differences were found among the 3 conditions. Analysis of service utilization also showed no significant differences among conditions, with almost half of youth receiving some additional services in the 1st year after beginning treatment, and roughly one third of youth in the 2nd year. Limitations include sample generalizability and inadequate power to test for higher order interactions (e.g., moderating effects of age, gender, ethnicity, therapist background, internalizing vs. externalizing problems), a sample characterized by a high degree of heterogeneity, and chosen measure of functioning was administered only at 1-year intervals.

Length of controlled postintervention follow-up: Varies but at least 12 months

Chorpita, B. F., Daleiden, E. L., Park, A. L., Ward, A. M., Levy, M. C., Cromley, T., Chiu, A. W., Letamendi, A. M., Tsai, K. H., & Krull, J. L. (2017). Child STEPs in California: A cluster randomized effectiveness trial comparing modular treatment with community implemented treatment for youth with anxiety, depression, conduct problems, or traumatic stress. Journal of Consulting and Clinical Psychology, 85(1), 13–25. https://doi.org/10.1037/ccp0000133

Type of Study: Randomized controlled trial
Number of Participants: 138

Population:

• Age — Youth: 5-15 years (Mean=9.30 years), Parents: Not specified
• Race/Ethnicity — Youth: 78% Latino/a, 10% African American, 8% Multiethnic, and 4% Caucasian; Parents: Not specified
• Gender — Youth: 55% Male, Parents: Not specified
• Status — Participants were youth whose primary clinical concerns involved diagnoses or clinical elevations related to anxiety, depression, disruptive behavior, and/or traumatic stress.

Location/Institution: Three different community agencies in Los Angeles County and San Bernardino County

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to report outcomes testing modular treatment [now called Modular Approach to Therapy for Children with Anxiety, Depression, Trauma, or Conduct Problems (MATCH-ADTC)] versus multiple community-implemented evidence-based treatments for youth. Participants were randomly assigned to 1 of 2 conditions: (a) modular treatment, which involved a single modular protocol (MATCH-ADTC) and (b) community-implemented treatment (CIT). Measures utilized include the Brief Problem Checklist (BPC), the Top Problems Assessment (TPA), the Revised Child Anxiety and Depression Scales (RCADS), the University of California at Los Angeles Post-traumatic Stress Disorder Reaction Index (UCLA PTSD Index), the Strength and Difficulties Questionnaire (SDQ), the Services Assessment for Children and Adolescents (SACA), the Services for Children and Adolescents Parent Interview (SCAPI), and the Client Satisfaction Questionnaire. Results indicate youth treated with MATCH-ADTC showed significantly faster rates of improvement over time on clinical and functional outcomes relative to youth in the CIT condition and required significantly fewer sessions delivered over significantly fewer days. Caregiver-reported clinical improvement rates were significantly greater for MATCH-ADTC (60%) versus CIT (36.7%). Further, youth in the CIT condition were significantly more likely to receive additional psychosocial treatment services and were significantly more likely to use a variety of psychotropic medications during the active treatment phase. Limitations included the lack of study cases for which trauma was selected as the primary treatment focus, the current study was not a controlled test of alternative designs for evidence-based treatments, and lack of follow-up.

Length of controlled postintervention follow-up: None.

Weisz, J. R., Bearman, S. K., Ugueto, A. M., Herren, J. A., Evans, S. C., Cheron, D. M., Alleyne, A. R., Weissman, A. S., Tweed, J. L., Pollack, A. A., Langer, D. A., Southam-Gerow, M. A., Wells, K. C., & Jensen-Doss, A. Testing robustness of Child STEPs effects with children and adolescents: A randomized controlled effectiveness trial. Journal of Clinical Child & Adolescent Psychology, 49(6), 883-896. https://doi.org/10.1080/15374416.2019.1655757

Type of Study: Randomized controlled trial
Number of Participants: 156 youth, 50 therapists

Population:

• Age — Youth: 6-16 years (Mean=10.52 years), Therapists: Mean=43.36 years, Caregivers: Not specified
• Race/Ethnicity — Youth: 80% Caucasian, 13% Multiracial, 5% Black, 2% Latino and 1% Other; Therapists: 40 White, 1 Hispanic, and 2 Other; Caregivers: Not specified
• Gender — Youth: 48% Male; Therapists: 33 Female; Caregivers: Not specified
• Status — Participants were youth with a primary problem or disorder of anxiety, depression, traumatic stress, and/or conduct problems.

Location/Institution: Three large outpatient community mental health clinics in urban, suburban, and rural areas

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to test robustness of beneficial effects found in two previous trials of the modular Child STEPs treatment program [now called Modular Approach to Therapy for Children with Anxiety, Depression, Trauma, or Conduct Problems (MATCH-ADTC)]. Fifty community clinicians were randomly assigned to receive training and consultation in Child STEPs or to provide usual care (UC). Referred youths were randomly assigned to Child STEPs or UC. Measures utilized include the Child Behavior Checklist (CBCL), the CBCL/Youth Self Report, the Brief Problem Checklist (BPC), and the Top Problems Assessment. Results indicate participants in both groups showed statistically significant improvement on all measures, leading to clinically meaningful problem reductions. However, in contrast to previous trials, Child STEPs was not superior to UC on any measure. Limitations include the number of youths referred and randomized but never appeared for treatment, the absence of a third study condition, and power was diminished for smaller effects.

Length of controlled postintervention follow-up: 2 years.