Using flexible clinical processes in the Unified Protocol for the Treatment of Emotional Disorders in Adolescence

The purpose of this manuscript is to highlight the Unified Protocol for the Treatment of Emotional Disorders in Adolescents (UP-A) as an exemplar model of a principle-based, flexible treatment for adolescents with either depressive or anxiety disorders. The theoretical basis, mechanism of change, and research support for three of the UP-A's guiding treatment principles are presented. Verbal exchanges between UP-A therapists and adolescent clients are shared to demonstrate clinical processes related to UP-A techniques that follow such guiding principles. The benefits of this approach to treatment are discussed, including reduction in the number of evidence-based treatment manuals to be learned, administered, and supervised. The UP-A has demonstrated positive outcomes, yet further examination of clinical process variables is warranted. These clinical process variables and additional future directions for the UP-A are addressed

Lessons Learned About Barriers to Implementing School-Based Interventions for Adolescents: Ideas for Enhancing Future Research and Clinical Projects

The majority of youth with mental health problems do not receive treatment, highlighting the critical need to transport evidence-based interventions into community settings, such as schools. Despite being able to reach a large number of adolescents and minority youth, the process of implementing evidence-based interventions to schools is challenging. This paper discusses some expected and unexpected challenges experienced during the implementation of an open trial and a pilot randomized controlled trial examining the acceptability and effectiveness of a school-based preventive intervention for adolescents at risk for internalizing disorders. First, we highlight key programs and findings on preventive interventions for adolescents at risk for depression and anxiety. Next, we provide a brief overview of the preventive intervention we implemented in schools. This provides a context for the section that describes implementation issues and highlights specific challenges and potential solutions for intervention implementation. Finally, the paper offers recommendations for researchers and clinicians interested in implementing school-based mental health services for adolescents. •School-based, preventive intervention for adolescents at risk for depression and anxiety•School-based prevention intervention processes involved in implementation•Specific challenges and potential solutions given for issues involved in implementation•Recommendations for implementing school-based mental health services for adolescent

A Pilot Study of the Feasibility and Efficacy of the Strategies to Enhance Positive Parenting (STEPP) Program for Single Mothers of Children With ADHD

Objective: The Strategies to Enhance Positive Parenting (STEPP) program was developed to address putative factors related to poor engagement in and outcomes following traditional behavioral parent training (BPT) for single mothers of children diagnosed with ADHD. Method: Twelve single mothers of children with ADHD were enrolled in an initial investigation of the feasibility and preliminary efficacy of the 9-week STEPP program. Results: Results indicated that the STEPP program was effective in reducing problematic child behavior and improving parental stress and psychopathology at posttreatment. The STEPP program resulted in high rates of treatment attendance and completion and consumer satisfaction with the program. However, results also indicated that the STEPP program did not improve childrens’ overall psychosocial impairment and resulted in small effect size findings across measures. Conclusion: The results of the pilot study are encouraging but indicate a need to improve the potency and delivery of certain aspects of the STEPP program