Empirically Supported Treatments Research Articles

Supporting psychosis research, implementation, and training through an academic intermediary-purveyor organization.

Intermediary-purveyor organizations (IPOs) are a type of dissemination support system that are intended to enhance the adoption and sustainment of empirically supported treatments (ESTs) by deploying empirically supported strategies to remediate implementation challenges. Despite the recent proliferation of government-funded IPOs for other psychiatric populations, IPOs that can redress the substantial science-to-practice gap among clients who experience psychotic disorders are not well documented. This article provides an overview of an IPO in an R1 academic medical center whose mission is to enhance access to evidence-based interventions for individuals who have or are at risk for a psychotic disorder. The article spotlights the functions of an IPO and illustrates these functions with a use case, cognitive behavioral therapy for psychosis. We highlight IPO-led activities related to cognitive behavioral therapy for psychosis purveyance, professional development, quality improvement, public awareness education and training, research and evaluation, as well as program and policy development. Finally, we address the advantages and disadvantages of establishing IPOs of this nature in academic medical centers, the importance of academic-community partnerships in advancing EST implementation, and present considerations for replication. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

An examination of internal family systems interventions for trauma with implications for ethical psychedelic-assisted treatment

AbstractThough several treatments effectively address the pervasive impact of trauma, they do not achieve complete symptom resolution for all clients, inspiring the search for alternatives. Internal Family Systems (IFS) therapy has grown popular, especially in informal psychedelic-assisted treatments (PAT). Compared to stereotypes of empirically validated, exposure-based treatments, IFS has novel facets with widespread appeal. The model encourages improved quality of interactions among multiple, naturally arising “parts” or subpersonalities potentially generated by traumatic experience. The body of IFS literature is extensive, enthusiastic, and thought-provoking. Outcome data for applying the model to Post-Traumatic Stress Disorder are limited. Attempts to operationalize and falsify the theory's assumptions and proposed mechanisms will likely prove challenging. Nevertheless, the model's popularity underscores a problem with perceptions of the empirically-supported treatments. Contemplating ethical ways to present the IFS approach given the state of relevant research, we note strategies that would apply to recommendations for PAT of any type. These strategies include detailed psychoeducation about empirically-supported treatments, candid description of the experimental nature of alternatives, frequent assessments of improvement, and detailed monitoring of potential iatrogenic effects. Drawing on facets of IFS to improve perceptions of the empirically validated treatments might provide an efficient way to appeal to more clients, decrease drop out, and increase gains as we await results of empirical investigations of IFS-influenced PAT. These steps can allow clients to choose an approach consistent with their own impressions of a credible intervention, potentially leading to better outcomes.

Principle-Guided Psychotherapy for Children and Adolescents (FIRST): study protocol for a randomized controlled effectiveness trial in outpatient clinics

BackgroundHundreds of youth psychotherapy randomized trials have generated scores of helpful empirically supported treatments (ESTs). However, the standardized structure of many ESTs and their focus on a single disorder or homogeneous cluster of problems may not be ideal for clinically referred youths who have comorbidity and whose treatment needs may shift from week to week. This concern has prompted development of flexible transdiagnostic, modular youth psychotherapies. One of these, designed for efficient training and implementation, is FIRST—a transdiagnostic intervention built on five empirically supported principles of change (i.e., feeling calm, increasing motivation, repairing thoughts, solving problems, and trying the opposite) and targeting common internalizing and externalizing youth mental health disorders and problems. FIRST has shown promise in improving youth mental health in three open trials. Now, in a more rigorous test, we seek to (1) conduct a randomized controlled trial comparing FIRST to usual care in real-world clinical practice settings; (2) examine a promising candidate mediator of change—regulation of negative emotions; and (3) explore variables that may influence clinicians’ treatment implementation.MethodsThis is an assessor-naïve randomized controlled effectiveness trial in youth outpatient community clinics in New England and Texas. Using double randomization, clinic-employed clinicians and treatment-referred youths (7–15 years old) are independently randomly allocated (1:1) to FIRST or usual care. We aim to recruit 212 youth participants, all referred through normal community pathways, with elevated symptoms of anxiety, depression, conduct problems, or post-traumatic stress. This study will test the effectiveness of FIRST compared to usual care on mental health outcomes, examine whether those outcomes are mediated by regulation of negative emotions, and explore clinician factors that may be associated with FIRST implementation and outcomes. Session recordings are coded to assess treatment fidelity.DiscussionThis study will evaluate the effectiveness of FIRST in youth community mental health settings, relative to the care usually provided in those settings. If FIRST is found to be effective, it could offer an efficient and practical method to increase use of empirically supported treatment principles in real-world practice contexts.Trial registrationNIH Clinical Trials Registry, NCT04725721. Registered 27 January 2021, https://clinicaltrials.gov/ct2/show/study/NCT04725721

Psychodynamic Therapies for the Treatment of Substance Addictions: A PRISMA Meta-Analysis.

The aim of this meta-analysis was to compare psychodynamic with other treatments in studies of substance addiction. The literature search was conducted using the PubMed, Web of Science, Cohcrane library, SCOPUS, and Onesearch databases. All studies comparing psychodynamic therapy with other types of psychological interventions for Substance Use Disorder were eligible. Three outcomes were considered to compare intervention performance: substance use, participation in treatment and other symptomatic conditions (OSCs). Hedges' G was used to measure effect size. The Revised Cochrane Risk of Bias tool for randomized trials was used to assess quality of evidence and possible bias, Egger regression analyses for publication bias, and Q and I-square statistics were used to assess heterogeneity. The alcohol group showed no differences between treatments on the three outcomes. The cocaine group showed no significant differences in the two outcomes, while for OSCs, available data was insufficient. The opioids group showed small but significant differences regarding participation in favor of non-psychodynamic interventions and no significant results for other outcomes. Based on the three measures of recovery considered in this meta-analysis, psychodynamic interventions were shown to be as effective as other psychological treatments in treating substance dependence and proved to be an empirically-supported treatment for the above addictions.

De-implementation of Low-Value Practices for Autism Spectrum Disorder.

Due to a variety of factors, Autism Spectrum Disorder (ASD) has long been tethered to use of low-value practice (LVP), arguably moreso than any other psychiatric or neurodevelopmental condition. Although dissemination of empirically supported treatments (EST) for autistic individuals has expanded markedly over the past decade, there has not been concomitant reduction in the use of LVP. It is critical that clinicians and scientists not only promote the implementation of EST, but also facilitate the de-implementation (abandonment and/or divestment) of ineffective or harmful practices. In this review, we describe a data-driven approach that can be used to identify LVP, drawing from established criteria for identification of evidence-based treatments (e.g., APA Division 12, National Clearinghouse on Autism Evidence and Practice; SAMHSA), as well as broader considerations such as social validity, cost, and parsimony. Herein, a data-based approach to LVP identification is proposed with a goal of improving quality of service access. Within an implementation science framework, we identify specific facilitators that sustain LVP use, and recommendations for subsequent de-implementation strategies are offered.

The status of psychodynamic psychotherapy as an empirically supported treatment for common mental disorders - an umbrella review based on updated criteria.

To assess the current status of psychodynamic therapy (PDT) as an empirically supported treatment (EST), we carried out a pre-registered systematic umbrella review addressing the evidence for PDT in common mental disorders in adults, based on an updated model for ESTs. Following this model, we focused on meta-analyses of randomized controlled trials (RCTs) published in the past two years to assess efficacy. In addition, we reviewed the evidence on effectiveness, cost-effectiveness and mechanisms of change. Meta-analyses were evaluated by at least two raters using the proposed updated criteria, i.e. effect sizes, risk of bias, inconsistency, indirectness, imprecision, publication bias, treatment fidelity, and their quality as well as that of primary studies. To assess the quality of evidence we applied the GRADE system. A systematic search identified recent meta-analyses on the efficacy of PDT in depressive, anxiety, personality and somatic symptom disorders. High quality evidence in depressive and somatic symptom disorders and moderate quality evidence in anxiety and personality disorders showed that PDT is superior to (inactive and active) control conditions in reducing target symptoms with clinically meaningful effect sizes. Moderate quality evidence suggests that PDT is as efficacious as other active therapies in these disorders. The benefits of PDT outweigh its costs and harms. Furthermore, evidence was found for long-term effects, improving functioning, effectiveness, cost-effectiveness and mechanisms of change in the aforementioned disorders. Some limitations in specific research areas exist, such as risk of bias and imprecision, which are, however, comparable to those of other evidence-based psychotherapies. Thus, according to the updated EST model, PDT proved to be an empirically-supported treatment for common mental disorders. Of the three options for recommendation provided by the updated model (i.e., "very strong", "strong" or "weak"), the new EST criteria suggest that a strong recommendation for treating the aforementioned mental disorders with PDT is the most appropriate option. In conclusion, PDT represents an evidence-based psychotherapy. This is clinically important since no single therapeutic approach fits all psychiatric patients, as shown by the limited success rates across all evidence-based treatments.

Enhancing Quality of Care Through Evidence-Based Practice: Training and Supervision Experiences.

Evidence-based practice (EBP) is the preferred approach to treatment in mental health settings because it involves the integration of the best available research, clinical expertise, and patient values to optimize patient outcomes. Training on empirically supported treatments (ESTs) in mental health settings is an important component of EBP, and supervision of therapists' implementation of ESTs is critical for therapists to develop and maintain a strong EBP skill set. This study aimed to evaluate training and supervision histories of therapists in outpatient and inpatient psychiatric care settings as an essential first step in improving patient outcomes. Electronic surveys were completed by 69 therapists, most of whom had a master's degree, within a psychiatry and behavioral sciences department at an academic institution. Participating therapists were recruited from several outpatient and inpatient mental health settings serving children, adolescents, and adults. Although most therapists reported completing some form of EST-related coursework, a majority did not receive any supervision related to implementation of ESTs (51% for cognitive-behavioral therapy cases, 76% for dialectical behavior therapy cases, and 52% for other EST cases) during graduate and postgraduate training. Although research from the past decade has supported the need for improvements in training on ESTs, and especially in supervision, problems related to limited exposure to training and supervision among therapists still exist. These findings have implications for how mental health centers can evaluate staff members' EST training and supervision experiences, training needs, and associated training targets to improve the quality of routine care.

Contradictions, methodological flaws, and potential for misinterpretations in ranking treatments of depression.

In this journal Malhi et al. recommended cognitive-behavior therapy (CBT), antidepressants, and counseling ahead of short-term psychodynamic therapy (STPP) referring to UK NICE guidelines for depression. However, these recommendations continue the ambiguous and therefore confusing NICE guidelines, which on the one hand list the above treatments as equal options as first-line treatment for depression and emphasizes the importance of patient preference and implementations factors, but on the other hand rank these first-line treatments, implying superiority of some treatments over others. Furthermore, we highlight several methodological flaws of the NICE treatment ranking and that the NICE treatment ranking is not justified by NICE's own and independent evidence and criteria. Presently it is not clear which patients benefit from which empirically-supported treatment. Thus, we continue to discourage the devaluing of efficacious treatments so that as many patients as possible may benefit from them.

Behandlingsmetoders rolle i evidensbasert psykologisk praksis

In 1995 the report from the American Psychological Association on empirically supported treatments (EST) boosted the understanding that evidence-based practice rested on the premise of matching treatments with diagnoses. Evidence-based psychological practice (EBPP) was developed partly as a response to this premise and described a broader foundation for good practice. However, EBPP did not give clear answers on the role and significance of treatment methods in evidence-based practice. The question remains an issue and has implications for the organization of service delivery to people with mental disorders. The goal of this article is to explore how clinicians could reason when faced with the question of which treatment method to choose. Even though different treatment methods may not differ notably in outcomes, there is still a need to establish their efficacy through research before integrating them in service delivery systems. Moreover, uncertainties exist regarding what the healing elements of psychotherapy are, as do challenges regarding the classification and conceptualization of mental disorders. Individual adaptation is an essential feature of EBPP, which implies that EBPP should be conceptualized as a dynamic process of hypothesis-based testing of methods in consultation with the client. Keywords: diagnoses, psychotherapy, treatment methods, evidence-based practice

Consultation competencies in prolonged exposure therapy for posttraumatic stress disorder.

The Emory University Prolonged Exposure (PE) Consultant Training Program seeks to develop a national network of competent PE consultants. Comprehensive training in empirically supported treatment (EST), such as PE, includes a didactic training followed by a period of experiential learning through consultation during real-world clinical practice (Karlin & Cross, 2014). Expert consultants are needed to meet demand as ESTs are disseminated. The Emory program has developed a training model to develop 18 consultation skills within five competency domains: the consultation relationship, general psychotherapy skills, PE-specific skills, trainee barriers to delivery, and implementation. The current article outlines these domains and discusses their theoretical background and applied value for PE consultant training, drawing on examples from the Emory program. Just as manualizing therapy has allowed for EST dissemination, the operationalizing of consultation competencies can provide a first step in disseminating evidence-based consultation practice. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Promising Effects of Socioemotional Skills Training in Bilingual Children With Attention and Behavioral Concerns

<h3>Research Objectives</h3> Bilingualism is present in every country of the world, class of society, and age group. Yet, monolingual-focused health practices, policies, and research dominate delivery of care, contributing to health disparities. To investigate the role of language in treatment delivery, the present study examined the effect of second language use on socioemotional skills in bilingual children with attention and behavioral concerns. <h3>Design</h3> A two-level (students, schools) cluster randomized controlled design accounted for treatment [Collaborative Life Skills (CLS) versus control] across 23 elementary schools. In addition, four schools received treatment in Spanish (parent group) and combination of Spanish and English (child skills training, classroom intervention). <h3>Setting</h3> The CLS program integrates empirically-supported treatments (parent training, classroom intervention, and child skills training) in school settings to encourage accessibility and sustainability. <h3>Participants</h3> Students were referred to the program by school staff for substantial inattention, hyperactivity/impulsivity, and/or related academic/social problems. We conducted secondary data analyses on 120 monolingual and 37 bilingual children (Grades 2-5, Mage=8.32, SDage = 1.08, 28% girls, 35% Latinx, 23% White, 18% Asian, 17% multiracial, 8% Black). <h3>Interventions</h3> Mental health professionals led nine 40-minute child group sessions during school hours. Modules targeted social functioning (e.g., self-control, friendship making, assertion) and independence (e.g., homework skills, routines). Socioemotional skills were taught through didactic instruction, behavioral rehearsal, and in-vivo practice. A reward-based contingency management program was used to manage behaviors and reinforce new skills. <h3>Main Outcome Measures</h3> ADHD symptoms, ADHD impairment. <h3>Results</h3> A mixed effects model revealed a treatment (CLS, control) by language status (bilingual, monolingual) interaction. A greater reduction in parent-reported impairment was found for bilingual children compared to monolingual children. <h3>Conclusions</h3> Socioemotional skills appear to especially benefit bilingual children with attentional and behavioral concerns. Future studies to understand mechanisms are warranted. Receiving socioemotional skills training in second language may help to down-regulate negative emotions, which may be conducive to learning socioemotional skills in clinical settings. <h3>Author(s) Disclosures</h3> No conflicts of interest to disclose.

Multiple needs and multiple treatments. What's a clinician to do? Update on the psychosocial treatment of disruptive behaviours in childhood.

Purpose of reviewThere are a wide range of psychosocial treatment options, delivered in different modalities, for children with disruptive behaviour. However, clinicians face many challenges in ensuring the empirically supported treatments (ESTs) they select will be effective for their patient. This has prompted studies to generate knowledge on how to improve treatment outcomes for children with disruptive behaviour. This review identifies the major challenges in treatment selection as well as emerging research seeking to improve outcomes.Recent findingsThis review emphasizes the salience of the research-practice gap associated with establishing ESTs using narrow definitions of clinical problems. Recent research is reviewed considering the complex determinants of disruptive behaviours, including parent and family factors that influence outcomes. The review subsequently outlines recent advances in research and clinical practice guidelines aiming to surmount these challenges. Key advances discussed include examining the most impactful components of ESTs, personalizing interventions by targeting core dysfunction underlying behaviour, and addressing parent factors including mental health and cultural relevance to improve outcomes.SummaryThorough assessment of patients’ needs, combined with knowledge of treatment response predictors, are recommended to determine the most suitable treatment plan. Recent advances have focused on developing and designing interventions that meet needs in a way that is flexible and tailored.

Intensive Cognitive-Behavioral Therapy for Anxiety Disorders in Adolescents: A Case Study

Anxiety disorders are one of the most common psychiatric conditions in youth and can contribute to impairment in social, academic, and family functioning. Cognitive-behavioral therapy (CBT) has been shown to be efficacious in treating youth anxiety disorders; however, for a multitude of reasons, fewer than 20% of adolescents with anxiety disorders receive services for anxiety-related problems. Intensive treatments, which rely on the same traditional components of CBT but are delivered over a shorter period of time or in a fewer number of sessions, may be particularly helpful for anxiety disorders and can offer a number of advantages over standard CBT. Despite emerging evidence supporting the advantages of the intensive approach, there are few established intensive treatment programs for youth with anxiety disorders. Further, no treatment to date has comprehensively targeted the entire spectrum of comorbid adolescent anxiety disorders in a combined intensive and transdiagnostic format, even though non-intensive (i.e., weekly delivered) CBT has been tested using a transdiagnostic approach. We developed an intensive, six-session intervention based on Angelosante and colleagues’ 2009 The Adolescent Panic Control Treatment with In-Vivo Exposures (Angelosante et al., 2009) and other empirically-supported treatments for youth to target all anxiety disorders in adolescents. We present a case study on an adolescent with multiple comorbid anxiety and related disorders who received intensive CBT treatment as a way to illustrate the clinical benefit and utility of an intensive, transdiagnostic approach. Findings support the acceptability and feasibility of transdiagnostic treatment of youth anxiety.

Development of Medication Administration Protocols for In-Home Pediatric Feeding Cases.

Medication administration can be a significant issue in pediatric populations, and especially with patients with developmental disabilities and comorbid feeding disorders. Research has focused largely on consumption of solids rather than medication and liquids in pediatric feeding programs, with most studies being conducted within specialized hospital settings in the United States. No studies to our knowledge have detailed treatment evaluations for medication administration in pediatric feeding except for a few studies on pill swallowing. We report results of treatment protocols for medication administration using empirically-supported treatments in a short-term intensive home-based behavior-analytic program in Australia. Two males with autism spectrum and pediatric feeding disorders participated. We used a multiple baseline single-case experimental design for medication administration conducted concurrently with a treatment evaluation for solid foods. Consumption increased in number (9; supplements, laxatives, pain relievers), flavors (8; chocolate, blackcurrent and apple, strawberry, lemon-lime, orange, chocolate-vanilla, cherry, apple), forms (4; thin and thick liquids, chewables, gummies), and delivery methods (5; finger-fed, spoon, cup, medicine spoon, medicine cup) within the first treatment session. For one participant, we taught open cup drinking for a variety of liquids (milk, juices, medications). For both participants, we taught self-feeding with utensils for thick liquid medications. Treatment results were similar for solids and participants increased food variety to over 160 across food groups. All goals were met including training parents to maintain gains at home.

Randomized controlled trial of motivational interviewing for alcohol and cannabis use within a predominantly Hispanic adolescent sample.

Hispanic youth represent one of the fastest-growing minority groups. Yet, we know little about Hispanic adolescents' response to empirically-supported interventions for adolescent addiction, including motivational interviewing (MI). This randomized controlled trial (RCT) compared MI to an active educational treatment for adolescent alcohol and cannabis use (alcohol and cannabis education; ACE). Adolescents who regularly use substances (N = 448; n = 347 Hispanic; n = 101 non-Hispanic white; ages 13-18) were randomized to two 1-hr individual sessions of MI or ACE. We examined 6-month outcomes and mechanisms of change across Hispanic and non-Hispanic white youth. Treatment response was comparable across ethnicities (Hispanic vs. non-Hispanic white youth). Additionally, adolescents in the MI condition showed greater reductions in alcohol use compared to those in ACE, with support for motivation and self-efficacy as mechanisms of treatment response. Direct effects of MI on cannabis use were not observed; however, a significant indirect effect of motivation was observed for reductions in cannabis use. Data support the efficacy of MI in reducing adolescent alcohol use, through the vehicle of enhanced motivation and self-efficacy. While consistent treatment response was observed for adolescent alcohol use across ethnicities (Hispanic vs. non-Hispanic white), further exploration into potential underexplored mechanisms of Hispanic adolescents' treatment response is requisite to strengthening prevention and intervention programming for Hispanic adolescents' cannabis use. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Social Validity of Paediatric Feeding Treatment across Goals, Processes, and Outcomes

Social validity of treatment for paediatric feeding disorders can be defined as the extent to which caregivers find treatment goals and procedures acceptable, and the level of satisfaction with the outcomes of treatment. However, there are few studies which examine social validity data, or that evaluate social validity against key treatment variables. The aim of this report was to compare caregiver ratings of treatment acceptability and satisfaction against treatment variables. Social validity measures were obtained from the caregivers of all children consecutively admitted to a home-based behaviour-analytic treatment programme for paediatric feeding disorders (N = 32) in Australia. All children (M = 6 years, range 2–13 y) had severe feeding problems and most had mealtime skill deficits and autism and developmental delays or intellectual disabilities. Social validity measures included treatment acceptability and satisfaction surveys. In a retrospective analysis, social validity scores were compared against variables including participant characteristics and goals, treatment procedures, and treatment outcome. The retrospective analysis identified no significant correlations. In this sample, caregiver social validity ratings were very high, and data-based treatment outcomes for all children showed high levels of clinical significance including consumption, food variety, and feeding skill development. This report is the first to examine social validity in a data-based manner. With the exception of duration of treatment, no further relations were identified. Whilst the findings may be impacted by little variability/ceiling effects, this further communicates that the empirically-supported treatment for a paediatric feeding disorders is highly effective, and highly valued by caregivers of children. It is recommended that further data-based research continue to examine further measures and determinants of social validity.

Word Retrieval Treatments in Aphasia: A Survey of Professional Practice

ABSTRACT Background Researchers have identified many assessment and treatment options for word retrieval impairments in individuals with aphasia. The extent to which these options are used in clinical practice is not well understood. Aims We surveyed speech-language pathologists to better understand their use and familiarity with word retrieval assessment and treatment approaches for individuals with aphasia. Methods & Procedures We developed a brief survey examining 12 assessment and 14 treatment approaches used in clinical practice for aphasic word retrieval impairments. An anonymous survey link was disseminated to speech-language pathologists. Outcomes & Results The experienced pool of 81 respondents report they commonly address word retrieval impairments. In assessment they primarily employ standardized aphasia and naming tests (e.g., Boston Naming Test; Kaplan et al., 2001). Many also use informal naming tools to supplement standardized testing. Three treatment approaches were used by the majority of respondents. Two approaches incorporate single word picture naming, cueing hierarchies and Semantic Feature Analysis, and a third fosters word retrieval in sentences, Verb Network Strengthening Treatment. Conclusions While word retrieval impairments are commonly addressed in clinical practice, further implementation science work is needed to examine clinical use of the many empirically-supported word retrieval assessment and treatment methods, including how their fidelity is maintained to foster positive outcomes across clinical settings.

The Relationship Between Treatment Prescription and Standardized Assessment for Youth With Identified Trauma, Behavior Problems, or Substance Use

The use of standardized assessment in evidence-based practice (EBP) is critical in identifying empirically supported interventions (ESIs); however, the subject has received minimal attention in the literature. In a sample of child welfare involved youth, this study sought to determine whether there was a relationship between dimensions of trauma exposure, emotional/behavioral problems, and substance use problems, as identified in the Child and Adolescent Needs and Strengths (CANS) assessment conducted by behavioral health providers, and the type of prescribed ESI. Bivariate analysis of variance (ANOVA), chi-square tests, and multivariate binary logistic regression results suggest clinicians use assessment information to varying degrees when prescribing an ESI. Close to 90% of the sample was prescribed an ESI intended to address emotional or behavior concerns. Approximately one-fourth of the sample was prescribed a trauma-focused ESI, while substance use-focused ESIs were the least frequently prescribed. As the intensity of assessed trauma-related problems increased, so too did the odds of receiving an ESI intended to address trauma. To a lesser degree, as assessed emotional/behavior problems or substance use issues increased, the probability of being prescribed a related ESI also increased. Implications for practitioners, administrators, policymakers, educators, researchers, and other behavioral health stakeholders are discussed.

A review of the inclusion of ethnoracial groups in empirically supported posttraumatic stress disorder treatment research.

Empirically supported treatments (ESTs) have been criticized for lack of ethnoracial representation, which may limit the generalizability of findings for non-White patients. This study assessed ethnoracial representation in United States-based randomized controlled trials (RCTs) for three evidence-based treatments for posttraumatic stress disorder (PTSD)-Prolonged Exposure (PE), Cognitive Processing Therapy (CPT), and Eye-Movement Desensitization and Reprocessing (EMDR). Representation was measured by explicit inclusion of people of color in published PTSD RCTs. Follow-up emails were sent to corresponding authors if full demographic information was not included in the reviewed manuscripts. Information concerning participant remuneration was collected for descriptive purposes. All three treatment modalities reported White participants as the majority in their sample. PE and CPT trials reported similar levels of ethnoracial diversity, while EMDR efficacy studies reported the least ethnoracial diversity. Across the reviewed studies, with few exceptions, we found low numbers of non-White participants in the majority of reviewed studies, which was compounded by poor or unclear methods of reporting ethnoracial information. This study demonstrates that the ESTs for PTSD are not adequately representative of the majority of non-White participants. Future RCTs should place a stronger emphasis on broad ethnoracial diversity in study participants to improve generalizability of findings. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Modified School-Based Facing Your Fears for Students with Autism Spectrum Disorder and Anxiety: A Preliminary Quasi-Experimental and Qualitative Analysis

With a high prevalence of anxiety among children with Autism Spectrum Disorder, researchers have identified implementing effective treatments in real-world settings as a priority. In the present study, multiple methods were employed to evaluate the effectiveness of educators delivering a modified school-based Facing Your Fears Cognitive Behavior Therapy program to treat anxiety among students with Autism Spectrum Disorder. Participants included 5 students, 6 educators and 7 parents. Settings were a public elementary school and private school. Multiple methods included a quasi-experimental group design, time series design, semi-structured interviews and focus groups. Quantitative results indicated that with training and on-going feedback educators obtained a modest level of fidelity in implementing the intervention. Non-significant decreases in student anxiety symptoms across all informant ratings (students, parents and teachers) were observed. Social validity ratings across participants were high. Qualitative findings revealed the following themes: (a) outcomes; (b) program structure; (c) inclusion; and (d) factors critical for success. These preliminary results offer a model for researchers to collaborate with key stakeholders in adapting interventions for use in schools, bridging the gap between research and practice. They highlight educator’s ability to deliver empirically-supported treatments to address anxiety among students with Autism Spectrum Disorder.