Clinical Interventions with Children and Adolescents

This chapter on clinical interventions with children and adolescents has four primary goals: (1) to review early efforts to identify evidence-based psychosocial treatments for youth and their families; (2) to provide an overview of current evidentiary support for the treatment of the four most prevalent psychiatric disorders in youth: anxiety disorders, mood disorders, attentional disorders, and oppositional/conduct disorders; (3) to examine relational and developmental factors that qualify and potentially moderate these efficacious treatments; and (4) to speculate on the future of psychotherapy research and practice with youth. Our review indicates that several evidence-based interventions are available, although with few exceptions they are cognitive-behavioral ones. However, we conclude that the evidence base even for these interventions is not overly robust at this time, and that we must evaluate other commonly practiced interventions such as play therapy, family systems therapy, and psychodynamic-based therapies before their routine use can be endorsed. We also identify important developmental, contextual, and relationship variables that qualify these efficacious findings and encourage the pursuit of additional process and outcome research. We conclude our discourse by suggesting that we must move beyond reliance upon manual-based treatments to the development of principle-based interventions that draw upon these specific evidence-based interventions but move beyond and unify them. Although much progress has occurred in the past 50 years, much work remains to be done. This is an exciting time in the child and adolescent psychotherapy arena.