Maine Implementation Study - Phase III

President and Fellows of Harvard College

Status: Completed

Conditions: Trauma; Depression; Anxiety; Problem Behavior

Treatments: Behavioral: Modular Approach to Therapy for Children; Behavioral: Usual Care Treatment

Study type: Interventional

Funder types: Other

Identifiers

NCT02229305

STEPs Phase III

Details and patient eligibility

About

This study focused on youths who were referred to community-based mental healths clinics for problems related to disruptive behaviors, depression, anxiety, traumatic stress, and any combination of these problems. Therapists were randomly assigned to deliver usual treatment procedures (usual care, or UC) in their clinics or an evidence-based, modularized treatment (Modular Approach to Therapy for Children with Anxiety, Depression, Trauma, or Conduct Problems, or MATCH-ADTC). Assessments were conducted at pre-treatment and post-treatment, and every 3 to 6 months for two years. Results will address critical questions about deployment of evidence-based youth practices to clinical settings.

Full description

This study focused on youths aged 6 - 15 who were referred to community-based mental healths clinics for problems related to disruptive behaviors, depression, anxiety, traumatic stress, and any combination of these problems. Using a randomized block design, therapists were randomly assigned to deliver usual treatment procedures (usual care, or UC) in their clinics or an evidence-based, modularized treatment (Modular Approach to Therapy for Children with Anxiety, Depression, Trauma, or Conduct Problems, or MATCH-ADTC). MATCH-ADTC was 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 evidence-based treatments. Assessments carried out at post-treatment and follow-ups included measures of (1) youth, caregiver, and therapist satisfaction with treatment; (b) youth, caregiver, and therapist views on the quality of the therapeutic relationship; and (c) treatment costs. Assessments carried out at follow-up only included measures of (a) caregiver reports of any mental health service use following project treatment; (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 settings.

Enrollment: 235 patients

Sex: All

Ages: 6 to 15 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• 6 - 15 year old and their caregivers
• seeking services at community mental health clinics
• primary problem or disorder related to anxiety, traumatic stress, depression, or conduct problems, or any combination of the four problems

Exclusion criteria

• Child is younger than 6 years or older than 15 years on the day of the phone screen
• Child has attempted suicide within the past year
• Schizophrenic spectrum disorders (including MDD with psychotic features)
• Autism or another Pervasive Developmental Disorder (E.g., PDD NOS, Asperger's Disorder, Child Disintegration 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 medication has not been regulated for one month or longer

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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235 participants in 2 patient groups

Usual Care Treatment

Active Comparator group

Description:

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

Treatment:

Behavioral: Usual Care Treatment

Modular Approach to Therapy for Children

Experimental group

Description:

Therapists used a modular manual (Modular Approach to Therapy for Children with Anxiety, Depression, Trauma, or Conduct Problems; Chorpita & Weisz, 2010) to help children with primary problems of anxiety, depression, trauma, and conduct.

Treatment:

Behavioral: Modular Approach to Therapy for Children