Journal
CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE
Volume -, Issue -, Pages -Publisher
EDUCATIONAL PUBLISHING FOUNDATION-AMERICAN PSYCHOLOGICAL ASSOC
DOI: 10.1111/cpsp.12367
Keywords
change mechanisms; change processes; children and adolescents; depression; evidence-based psychotherapies; mediators
Categories
Funding
- National Institute of Mental Health [MH068806, MH085963, MH093511]
- Harvard University Travel Grant
- Norlien Foundation
- Institute of Education Sciences [R305A140253]
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Psychotherapy for youth depression is only modestly efficacious. Investigating treatment mediators may guide improvement. Among 46 randomized trials of cognitive behavioral therapy and interpersonal psychotherapy with depressed youths, 74% measured candidate mediators (CMs), but only 17% analyzed CMs as mediators. Although four significant CMs emerged, findings were sparse, conflicting, and clouded by methodological issues. We see enormous untapped opportunity in the ample data collected but not yet analyzed using recommended methods. We propose exploiting existing data using mediation meta-analysis, broadening the range of CMs and the rigor of assessments, making measurement longitudinal and idiographic to clarify temporal precedence of CMs over outcomes and detect individual differences, and markedly altering journal and funder policies to promote change process and mechanism research.
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