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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

NCJ Number
Journal of Consulting and Clinical Psychology Volume: 85 Issue: 1 Dated: 2017 Pages: 13-25
Date Published
13 pages

The authors of this paper suggest that that a modular, multi-focus treatment program yields superior rates of improvement on clinical, functional, and utilization outcomes for youth receiving community mental health services.


This study reports outcomes from a randomized effectiveness trial testing modular treatment versus multiple community-implemented evidence-based treatments for youth. The authors used an ethnoracially diverse sample of 138 youth ages five to 15 (62 girls, 76 boys) whose primary clinical concerns involved diagnoses or clinical elevations related to anxiety, depression, disruptive behavior, and/or traumatic stress who were treated by community therapists; participants were randomly assigned to either of two conditions: (a) modular treatment, which involved a single modular protocol (i.e., modular approach to therapy for children; MATCH) that allowed flexible selection and sequencing of procedures to fit the chosen treatment focus in the context of measurement feedback; or (b) community-implemented treatment (CIT), which was a county-supported implementation of multiple evidence-based practices for youth. Results showed that youth treated with MATCH had 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 (60 percent) versus CIT (36.7 percent). Additionally, 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. Conclusions: These results extend prior findings, supporting the effectiveness and efficiency of a modular, multi-focus approach that incorporates monitoring and feedback relative to community implementation of evidence-based treatments. Publisher Abstract Provided

Date Published: January 1, 2017