Does It Work in the Real World? The Effectiveness of Treatments for Psychological Problems in Children and Adolescents

Despite the availability of hundreds of treatment studies in the scientific literature, we know little about whether these treatments work in regular practice. We present an updated review of treatment effectiveness studies for psychological problems in children and adolescents. A literature search yielded 20 recent articles describing effectiveness studies for the treatment of anxiety disorders, depression, and disruptive behavior problems. We compared data from these effectiveness studies with two benchmarks reported in meta-analyses of efficacy trials: the numbers of clients who completed services and the improvements found in those who completed services. All studies of the treatment of internalizing disorders reported completion rates above 80%; the majority of parenting interventions for the treatment of disruptive behavior problems reported that more than 75% of parents who began services completed them. The improvement rates reported in effectiveness studies for internalizing problems were comparable to the benchmarks reported in efficacy studies. There was greater variability in the treatment of disruptive behavior problems, with several studies outperforming the benchmark, and a smaller number yielding poorer results. Practitioners should be encouraged to see promising results that suggest evidence-based treatments for child and adolescent disorders can be effective when used in typical clinical settings.