The authors discuss the longer-term effectiveness and outcomes of the Child STEPs program, based on a two-year trial period.
This paper reports on outcomes from the Child STEPs randomized effectiveness trial conducted over a two-year period to gauge the longer-term impact of protocol design on the effectiveness of evidence-based treatment procedures. The authors used an ethnoracially diverse sample of 174 youths ages seven to 13 (N = 121 boys) whose primary clinical concerns involved diagnoses or clinical elevations related to anxiety, depression, or disruptive behavior were treated by community therapists randomly assigned to one of three 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 Treatment of Children With Anxiety, Depression, or Conduct Problems; MATCH) having clinical procedures similar to the standard condition but flexibly selected and sequenced using a guiding clinical algorithm, and (c) usual care. Results showed that as measured with combined Child Behavior Checklist and Youth Self-Report Total Problems, Internalizing, and Externalizing scales, the rate of improvement for youths in the modular condition was significantly better than for those in usual care. On a measure of functional impairment (Brief Impairment Scale), no significant differences were found among the three conditions. Analysis of service utilization also showed no significant differences among conditions, with almost half of youths receiving some additional services in the first year after beginning treatment, and roughly one third of youths in the second year. The authors conclude that overall, these results extend prior findings, supporting incremental benefits of MATCH over usual care over a two-year period. Publisher Abstract Provided