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Contents

Preface

Acknowledgments

Contributors

Part I: Overview and Foundational Issues

Chapter 1: Rationale and Standards of Evidence in Evidence-Based Practice

Evidence-Based Medicine

Current Status of EBP Movements Across Health and Education Professions

Evidence in Psychology

Treatment Guidelines

Children, Adolescents, and Evidence-Based Practice in Psychology

Limitations of The Evidence Base Regarding Evidence-Based Practice in Psychology

Concluding Remarks

References

Chapter 2: Evidence-Based Practice in Child and Adolescent Disorders

A Brief History of Identifying Evidence-Based Practices for Youth

What Do We Know About Ebps for Youth?

What Do We Still Need to Know About Ebps for Youth?

Use of EBPs in Real Life Settings

What Determines Whether Clinicians Use EBPs?

How Should EBPs Be Transported to Clinical Settings?

Summary

References

Chapter 3: Professional Issues and Evidence-Based Practice

Evidence-Based Practice and Empirically Supported Treatments: Use, Nonuse, and Misuse

Quality Improvement

A Brief History of The Problem of Quality

What is Quality Improvement?: A Primer

Examples of Concrete Steps to Improve Quality in Behavioral Health

References

Chapter 4: Developing Clinical Guidelines for Children and Adolescents

Developing Clinical Guidelines

The National Collaborating Centre for Mental Health

The Nice Mental Health Guidelines

Key Aspects of Nice Recommendations

What Impact Has Nice had on Mental Health Practice?

The Child and Adolescent Mental Health Services Evidence-Based Practice Unit

Health Care Commission Audit of Nice Schizophrenia Guidelines

Future Developments in Nice Clinical Guidelines

References

Chapter 5: The Economics of Evidence-Based Practice in Disorders of Childhood and Adolescence

Background: The Incredible Years Series

Economics of Implementing EBP: Payers, Providers, and Consumers

Conclusion

References

Part II: Specific Disorders

Chapter 6: Intellectual Disabilities

Overview of Disorder

Aggressive Behavior

Self-Injurious Behavior

Stereotypic Behavior

PICA

Rumination

Food Refusal

Sleep Problems

Anxiety Disorders

Mood Disorders

Offending

Evidence-Based Practice

References

Chapter 7: Learning Disabilities

Overview of The Disorder

The Response to Intervention Model

Evidence for Response to Intervention

Reading Skills

Reading Comprehension

Written Expression

Mathematical Skills

Mathematical Calculation

Mathematical Reasoning

Evidence-Based Treatment of Learning Disabilities

References

Chapter 8: Stuttering

Overview of Disorder

Evidence-Based Treatment and Stuttering

Verbal Response Contingent Stimulation

Speech Restructuring

Cognitive Behavior Therapy

Rhythmic Stimulation

Machine-Driven Therapies

Family-Based Early Intervention

Evidence-Based Practices

References

Chapter 9: Autism Spectrum Disorders

Overview of Disorder

Comprehensive Treatment Programs

The TEACCH Program

Developmental Interventions

Social Skills Interventions

Increasing Social Interaction Skills

Communication Interventions

Inappropriate Behavior

Conclusions

References

Chapter 10: Attention-Deficit/Hyperactivity Disorders

Overview

Core Symptoms

Prevalence and Demographic Variables

Impact of ADHD

Comorbid Disorders

Developmental Course

Treatment Approaches

Behavior Modification

Summer Treatment Program

Evidence-Based Practices

References

Chapter 11: Conduct, Oppositional Defiant, and Disruptive Behavior Disorders

Overview of the Disorders

Interventions for DBD

Behavioral Parent Training

Cognitive Behavioral Interventions (CBI)

Other Interventions

Conclusions Regarding Evidence-Based Practices for DBD

References

Chapter 12: Pica

Overview of Disorder

Data-Based Treatment Studies

Behavioral Interventions

Meta-Analysis of Behavioral Studies

Evidence-Based Treatment of Pica

References

Chapter 13: Pediatric Feeding Disorders

Overview of Disorder

Empirically Supported Treatment of Pediatric Feeding Disorders

Evidence-Based Practices

References

Chapter 14: Tics and Tourette Disorders

Overview of Tic Disorders

Habit Reversal Training

Exposure and Response Prevention

Cognitive Behavior Therapy

Massed Negative Practice

Self-Monitoring

Contingency Management

Relaxation

Supportive Psychotherapy

Evidence-Based Practices

References

Chapter 15: Encopresis

Overview of Encopresis

Treatments for Constipation: Laxatives

Treatment: Medical-Behavioral Interventions

Proposed Mechanisms of Action

Evidence-Based Practices

References

Chapter 16: Enuresis

Overview of Disorder

Pharmacological Interventions

Behavioral Interventions

Evidence for Retention Control Training

Evidence for Reinforcement-Based Procedures

Evidence of Effectiveness of Dry Bed Training

Overview of Research on Behavioral Treatments

Other Treatment Approaches

Evidence-Based Practices for Enuresis

References

Chapter 17: Separation Anxiety Disorder

Overview of Disorder

Treatment of Separation Anxiety Disorder

Ease of Dissemination

References

Chapter 18: Reactive Attachment Disorder and Severe Attachment Disturbances

Overview of Disorder

Overview of Treatment Models

Alternative Treatment Studies That May Be Relevant

General Conclusions

References

Chapter 19: Stereotypic Behavior Disorder

Overview of Stereotypic Behavior Disorder

Empirically Supported Treatment of SBD

Well-Established Function-Based Treatments

Well-Established Non-Function-Based Treatments

Possibly Efficacious Non-Function-Based Treatments

Evidence-Based Practices

References

Chapter 20: Self-Injurious Behavior

Overview

Applied Behavior Analysis

Snoezelen

Sensory Integration Therapy

Social Stories

Other Psychosocial Treatments

Evidence-Based Practices

References

Chapter 21: Smoking in Children and Adolescents

Overview of Disorder

Evidence-Based Prevention and Treatment of Smoking in Children and Adolescents

Prevention

Treatment

Evidence-Based Practices

References

Chapter 22: Depressive Disorders in Children and Adolescents

Overview of Depressive Disorders

Evidence-Based Treatment Criteria

Cognitive Behavior Therapy

Interpersonal Psychotherapy

Review of Meta-Analyses

Moving Beyond Efficacy

Evidence-Based Practice

References

Chapter 23: Anxiety Disorders in Children and Adolescents

Introduction

Background

Conclusion

References

Chapter 24: School Refusal

Overview of Disorder

Demographic Variables

Impact of Disorder

Assessment

Treatment

Cognitive and Behavioral Therapies

Pharmacological Treatment

Conclusions

References

Chapter 25: Anorexia Nervosa

Overview of The Disorder

Sources of Information for This Report

Weight Restoration/Nutritional Rehabilitation

Cognitive Behavior Therapy

Family-Based Therapy

Cognitive Analytic Therapy

Summary

References

Chapter 26: Bulimia

Overview of Disorder

Empirically Supported Treatments for Bulimia Nervosa

Psychological Treatments

Interpersonal Psychotherapy for BN (IPT-BN)

Other Psychological Treatments

Psychopharmacological Treatments

Relative Efficacy of Psychosocial Treatments to Pharmacological Treatments

A Note on The Meta-Analyses of Group Designs

Evidence-Based Practices

References

Chapter 27: Sleep Disorders in Children

Overview of Disorder

Consensus Panel Recommendations

Extinction

Preventative Parental Education

Graduated Extinction

Faded Bedtime/Positive Routines

Scheduled Waking

Evidence-Based Practices

References

Chapter 28: Child Abuse and Neglect

Overview of Disorder

Interventions for Maltreating Behavior

Conclusions

References

Author Index

Subject Index

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Preface

Eysenck (1957) concluded that “the figures fail to support the hypothesis that psychotherapy facilitates recovery from neurotic disorder” (p. 322), but by 1977 Smith and Glass could conclude, after reviewing 375 studies, that “findings showed psychotherapy to be effective” (p. 752). Over the next 35 years interest in psychotherapy outcomes research flourished and is no mere idle academic question, but an issue for public policy, and now directs the expenditures of public health monies on a national scale in some countries. Currently, professional organizations, such as the American Psychological Association, and national organizations, such as the United Kingdom’s National Institute of Clinical Excellence (NICE), periodically publish lists of therapies that meet standards for evidence-based practice; the NICE goes further and influences national spending and professional training in disseminating and evaluating evidence-based practices in large-scale routine service settings. Psychotherapy outcome research has come a long way since Eysenck’s dystopic conclusion.

This first volume of Handbook of Evidence-Based Practice in Clinical Psychology shows that in the area of child and adolescent disorders there has been much progress in identifying and disseminating evidence-based practices. Each chapter documents the large amount of research that now identifies evidence-based practices for most disorders. To be sure, some disorders have very large evidence bases that permit greater confidence in conclusions and answers to more specific questions, such as which of several treatments might be most effective; others have more modest databases, permitting only modest and less certain conclusions.

Various forms of cognitive behavior therapy predominate as evidence-based practices, although in other areas—such as intellectual disabilities, autism spectrum disorders, and pica—behavioral treatments alone are at the forefront. For some disorders, certain forms of psychotherapy, such as interpersonal psychotherapy, meet the criteria for evidence-based practice. As evidence continues to accumulate these conclusions may change.

This volume is in two parts. Part I of this volume addresses general issues such as what the standards of evidence are, professional issues, and economics of evidence-based practice. Part II addresses many specific disorders of childhood and adolescence.

We believe that this volume presents a snapshot of an ever-developing field. It provides therapists, teachers, students, and other practitioners a starting point to become familiar with evidence-based practice in clinical psychology. It challenges psychology teachers to see if they teach evidence-based psychotherapies and also challenges service providers and finders to examine their own practices to see if they provide evidence-based practice.

REFERENCES

Eysenck, H. J. (1957). The effects of psychotherapy: An evaluation. Journal of Consulting Psychology, 16, 319–324.

Smith, M. L., & Glass, G. V. (1977). Meta-analysis of psychotherapy outcome studies. American Psychologist, 32, 372–360.

Acknowledgments

We would first like to thank our authors. Many of them undertook an enormous task of summarizing sometimes hundreds of articles, systematic literature reviews, and consensus panels and at times reviewing the outcome literature for many different forms of treatment for one disorder. They faced the challenge of being accurate and fair in identifying those practices that the literature support, those that researchers have little convincing evidence to support, and those that research has shown to be ineffective or harmful. We believe they all succeeded in doing so. We would both like to express our unending thanks to Carole Londeree’s persistent and cheerful technical assistance throughout this project. Finally, we would like to express our thanks to the editorial staff at John Wiley & Sons who worked so hard to make this project a success.

Contributors

Nancy D. Berkman, PhD, is a Senior Health Policy Research Analyst at RTI, International. She has led the development of four systematic reviews of the literature for the Agency for Healthcare Research and Policy’s Evidence-based Practice Center Program (EPC) including management of eating disorders. Dr. Berkman is currently the Project Director for an EPC-sponsored project developing, refining, and coordinating qualitative methods research related to conducting systematic and comparative evidence reviews of the literature.

Jonathan Breidbord is a graduate student at the University of Cambridge and has interest in childhood developmental conditions, critical appraisal, and metric meaningfulness.

Kimberly A. Brownley is Assistant Professor of Psychiatry at the University of North Carolina at Chapel Hill with a broad background in cardiovascular and neuroendocrine stress research. Her current and most recent work focuses on the psychobiology of appetite regulation and its application to understanding the etiology and consequences of eating disorders, psychotropic medication-induced weight gain, functional dyspepsia, and ethnic disparities in obesity.

Jennifer L. Bruzek, PhD, is a Postdoctoral Fellow in the Kennedy Center at Vanderbilt University. She has published several scholarly papers on intellectual disabilities, child-parent interactions, and behavior analysis.

Cynthia M. Bulik is the Jordan Distinguished Professor of Eating Disorders in the Department of Psychiatry in the University of North Carolina School of Medicine, Professor of Nutrition in the Gillings School of Global Public Health, and Director of the University of North Carolina Eating Disorders Program.

J. Gerard Byrne is a Consultant Child and Adolescent Psychiatrist at the Lucena Clinic, Dublin, Eire. He specializes in attachment theory in children and adolescents.

Mark J. Chaffin is a Professor of Pediatrics at the University of Oklahoma Health Sciences Center, and director of research for Developmental and Behavioral Pediatrics and the Center on Child Abuse and Neglect. His research interests include development and implementation of prevention and intervention models in child abuse and child welfare settings. Dr. Chaffin serves on the advisory board of the California Evidence Based Clearinghouse for Child Welfare.

Jane E. Cole is an Assistant Professor of Special Education at Miami, Ohio University. She received her PhD from the University of Virginia in 2007. Her research interest is primarily in the area of mathematics assessment and intervention for students with high incidence disabilities.

Christine A. Conelea received her MS in Clinical Psychology from the University of Wisconsin-Milwaukee and is currently completing her predoctoral internship at the Alpert Medical School of Brown University. Ms. Conelea has authored or coauthored 18 papers or chapters on tic disorders, trichotillomania, obsessive-compulsive disorder, and other repetitive behavior problems, and has clinical and research interests in the phenomenology, maintenance, impact, and treatment of these disorders.

Joshua Cooper is a CUNY Graduate Center doctoral student in the Queens College Learning Processes and Behavior Analysis program. He is currently involved in research investigating equivalence classes and procedures to induce joint stimulus control.

Felicity Cowdrey completed her undergraduate degree in Psychology and Cognitive Neuroscience at the University of Nottingham. She is currently a DPhil candidate at the Department of Psychiatry, University of Oxford. Her current research interests include the cognitive and emotional processes that maintain eating disorders, especially anorexia nervosa.

Angie Dahl is a doctoral student in the Clinical, Counseling and School Psychology PhD Program at Utah State University in Logan, Utah. Her research focuses on factors related to optimal developmental outcomes in child and adolescent populations and she is employed as a school psychologist.

Amy L. Damashek is an Assistant Professor of Clinical Psychology at Western Michigan University. She teaches and provides clinical supervision in Western Michigan University’s clinical psychology doctoral program. She received her PhD from the University of Missouri and completed a postdoctoral fellowship at the University of Oklahoma Health Sciences Center, Center on Child Abuse and Neglect. Her research interests include prevention of unintentional child injuries and child maltreatment. Her recent research has focused on the role of caregiver supervision in children’s unintentional injuries. She is also interested in research on dissemination of evidence-based child maltreatment interventions.

Robert Didden is Professor of Intellectual Disabilities, Learning and Behavior at the Behavioural Science Institute of the Radboud University Nijmegen, the Netherlands. He also is head of Trajectum Center of Expertise and a psychologist at Trajectum Hanzeborg, a center for the care and treatment of individuals with mild intellectual disability. His research and clinical interests include behavioral and psychiatric disorders in intellectual disability and/or autism spectrum disorders.

Klaus Drieschner is senior research psychologist at Trajectum, a treatment center for individuals with mild intellectual disabilities and serious problem behavior or offending behavior. His research interests include the effectiveness of correctional treatment, treatment motivation, and test construction.

Paul M. G. Emmelkamp is a licensed psychotherapist and clinical psychologist and full professor of clinical psychology at the University of Amsterdam. Over the years, he has published widely on the etiology and treatment of anxiety disorders. He is involved in therapy-outcome studies on adults with work-related distress, substance abuse disorders, personality disorders, depression, and anxiety disorders; on youth with ADHD, conduct disorder, and anxiety disorders; and on the elderly with anxiety disorders. He has written and coedited many books, and has over 350 publications in peer-reviewed journals or books. He has received a number of honors and awards, including a distinguished professorship (“Academy Professor”) by the Royal Academy of Arts and Sciences.

Gregory A. Fabiano is an Associate Professor in the Department of Counseling, School and Educational Psychology at the University at Buffalo–SUNY. His research focuses on evidenced-based practices for children and adolescents with attention-deficit/hyperactivity disorder (ADHD).

Clint Field is an Assistant Professor of Psychology at Utah State University in Logan, Utah. He conducts research related to applied behavior analysis, parent-child interaction patterns (particularly as they relate to the treatment of childhood disorders), and the early intervention and primary prevention of children’s conduct problems.

Peter Fonagy is Freud Memorial Professor of Psychoanalysis, Head of the Research Department of Clinical, Educational and Health Psychology at University College London and Chief Executive at the Anna Freud Centre, London. He is a clinical psychologist and training and supervising analyst in the British Psycho-Analytical Society in child and adult analysis. His clinical interests center around issues of borderline psychopathology, violence, and early attachment relationships. His work attempts to integrate empirical research with psychoanalytic theory. He chaired the guideline development group for the National Institute for Health and Clinical Excellence’s clinical guideline on childhood depression.

E. Michael Foster is professor at the Gillings School of Global Public Health, University of North Carolina at Chapel Hill. His research focuses on the statistical methods of causal inference and the economic evaluation of programs and interventions for at-risk children and youth.

Kurt A. Freeman is an Associate Professor of Pediatrics and Psychiatry at Oregon Health and Science University of Portland, Oregon. He has published on behavioral assessment and intervention strategies for common to severe child rearing challenges including bedtime/sleep problems, parenting practices, conduct problems, and aberrant behavior in individuals with developmental disorders.

Sarah Gebhardt is currently a doctoral student in the school psychology program at Lehigh University. She received her master’s degree from Miami, Ohio University in 2009. Her research interests include applied behavior analysis and pediatric psychology.

Ata Ghaderi’s research focuses on eating disorders, including identifying risk and protective factors in the development of eating disorders among young women in the general population, the prevalence and incidence of eating disorders and interventions for eating disorders including refinement of cognitive behavioral treatment (CBT) as well as CBT-based self-help for bulimia nervosa, binge eating disorder, and other eating disorders not otherwise specified.

Tamlynn D. Graupner is cofounder and Chief Executive Officer of the Wisconsin early Autism project. She is currently completing a doctoral degree in pediatric neuropsychology and conducting a study of brain structure and functioning using fMRI neuroimaging with adolescents who received intensive behavioral therapy as toddlers.

Alan M. Gross is Professor of Psychology and Director of Clinical Training at the University of Mississippi. His research interests are in the area of behavior problems in children and sexual assault.

Rebecca J. Hamblin is a graduate student in Clinical Psychology at the University of Mississippi. Her research interests are in internalizing and externalizing disorders in children and implementation of effective treatments in school settings.

Michael Handwerk, PhD, is a Clinical Psychologist at Harrisburg Medical Center in southern Illinois. He conducts research on the assessment and treatment of disruptive behavior disorders, variables relating to the development of antisocial and aggressive behavior, and the effectiveness of residential care.

Marianne Jackson received her master’s and doctoral degrees in Behavior Analysis from the University of Nevada, Reno. She is currently an Assistant Professor at California State University, Fresno, where she also serves as codirector of the Central California Autism Center and continues to pursue her research interests in the development of derived relational responding, the role of derived responding complex human behavior, and the processes of verbal motivation. Areas of clinical interest include problem behavior, teaching the basic processes of verbal behavior, verbal processes in health and fitness, and the development of complex social skills.

Anthony James is Honorary Senior Lecturer, University of Oxford, and Consultant Child and Adolescent Psychiatrist. His research interests include early-onset psychoses and anxiety disorder.

Christine James studied biomedical sciences at University College London and is currently doing an MSc at Kings College, London.

Mark Jones is a biostatistician for the Centre for Healthcare Related Infection Surveillance and Prevention, Queensland Health, and is also an Adjunct Senior Lecturer with the School of Population Health, the University of Queensland. He has a strong interest in stuttering treatment research, clinical trials, and biostatistics. He leads the team at the Australian Stuttering Research Centre with the design of clinical trials, and has led the team in developing new outcome measures for clinical trials of stuttering treatments.

Craig H. Kennedy is Associate Dean for Research and Professor of Special Education and Pediatrics at Peabody College of Vanderbilt University. He has published over 180 scholarly papers and books on intellectual disabilities, autism, instructional methods, and behavior analysis.

Russell Lang is Assistant Professor of Special Education at Texas State University, San Marcos, Texas. His research has involved the use of applied behavior analysis in the treatment of problem behavior and in the instruction of communication, academics, and self-help skills for individuals with developmental disabilities.

Giulio E. Lancioni is a professor in the Department of Psychology at the University of Bari, Italy. His research interests include the development and evaluation of assistive technology, social and adaptive skills training, and strategies for examining and teaching choice with individuals with severe or profound and multiple disabilities.

Michelle Levine graduated from the University of Rochester in 2009 with a BA in Brain and Cognitive Sciences. She is currently a research assistant at the Yale Child Study Center and plans to pursue a PhD in clinical psychology in the near future.

Scott O. Lilienfeld is a faculty member in the Department of Psychology at Emory University, Atlanta, since 1994. His research interests include the causes and assessment of personality disorders and personality traits, personality assessment psychiatric classification and diagnosis, pseudoscience and clinical psychology, evidence-based clinical practice, scientific thinking and its application to psychology, and philosophical psychology.

Maya S. Madzharova is doctoral student at the Learning Processes and Behavioral Analysis program at the Graduate Center and Queens College, City University of New York. Her current research focuses on developing effective strategies to train staff and parents and to increase peer-to-peer interactions among individuals diagnosed with ASD.

Lindsay Maffei-Almodovar is a doctoral student in the Learning Processes and Behavior Analysis subprogram of the Psychology Department at the CUNY Graduate Center. Her research focuses on training caregivers to use evidence-based behavior analytic practices in teaching children with developmental disabilities.

Jessica Malmberg is a doctoral student in the Clinical, Counseling, and School Psychology PhD Program at Utah State University in Logan, Utah. Central to her research interests are variables related to the development, display, and modification of disruptive behavior problems exhibited by children. She has particular interest in studying associated risk factors and in establishing primary prevention strategies for such problems of childhood.

William Martinez is a graduate student in the Clinical-Child Psychology doctoral program at DePaul University in Chicago. In 2010, he was awarded a Mental Health and Substance Abuse Services Fellowship through the American Psychological Association’s Minority Fellowship Program. His research interests include the development, implementation, and dissemination of evidence-based treatment programs for urban, ethnic minority youth with a particular emphasis on treatments for anxiety and trauma in Latino youth populations. In addition, he is interested in the assessment of internalizing symptoms, including evaluating the psychometric properties and measurement equivalence of instruments used with ethnic minority populations.

Michael E. May is Assistant Professor of Special Education at Southern Illinois University. He has published several scholarly papers on intellectual disabilities, gene-brain-behavior, aggression, and behavior analysis.

Michael W. Mellon is a pediatric psychologist in the Department of Pediatrics at Cincinnati Children’s Hospital Medical Center with prior appointments at Arkansas Children’s Hospital and the Mayo Clinic. Dr. Mellon earned his PhD from the University of Memphis and completed an internship at the University of Mississippi Medical Center. He currently provides psychotherapy to children with inflammatory bowel disease. He has published and presented papers in the areas of behavioral treatments for enuresis and encopresis and attention-deficit/hyperactivity disorder. Current research activities include developing and validating efforts to adapt acceptance and commitment therapy to patients with irritable bowel syndrome.

Glenn A. Melvin is a psychologist and lecturer at the Centre for Developmental Psychiatry and Psychology, School of Psychology and Psychiatry, Monash University, Melbourne, Australia. After completing a PhD in the treatment of adolescent depression at Monash University, he spent 2 years working as research scientist in the Division of Child and Adolescent Psychiatry at the New York State Psychiatric Institute. He is currently an investigator on a National Health and Medical Research Council funded clinical trial investigating psychosocial and pharmacological approaches to school refusal. Glenn’s other research and clinical interests include assessment and treatment of pediatric internalizing disorders, irritability, responses to trauma, and suicide risk.

Ross Menzies works at the Australian Stuttering Research Centre, Faculty of Health Sciences, the University of Sydney. He a clinical psychologist with an interest in the origins and management of anxiety, and has a private practice in Sydney. He has developed cognitive behavior therapy packages for the treatment of obsessive-compulsive disorders and published theories of the origins of phobias. He led the Australian Stuttering Research Centre team in clarifying the role of anxiety in stuttering and its deleterious effects on speech rehabilitation

David B. McAdam is an Assistant Professor of Pediatrics at the University of Rochester School of Medicine and Dentistry. His research interests include the functional analysis and assessment of problem behavior, pica, and applied behavioral analytic interventions for persons with autism.

Kimberly McCombs-Thornton has worked with numerous nonprofits serving young children and families. Most recently, she and E. Michael Foster developed a plan for conducting an economic evaluation of a system-wide early childhood initiative for First 5 Los Angeles. She also has done extensive data analysis with large secondary data sets including the Fragile Families and Child Wellbeing Study, the National Study of Child and Adolescent Wellbeing, the National Longitudinal Survey of Youth, and the National Longitudinal Transition Study-2.

Rob McNeill is a Lecturer in the School of Population Health at the University of Auckland. His primary research interests are in the area of health services research and evaluation and he has taught research methods for over 10 years.

Oliver C. Mudford is Senior Lecturer in Psychology and Director of the Applied Behavior Analysis Program at the University of Auckland, New Zealand. His research and publications are on interventions, particularly with intellectual disabilities and/or developmental disorders, and applied behavior analysis methods. He is a member of the editorial boards of six scientific journals in those fields.

Maaike H. Nauta is an Assistent Professor at the Department of Clinical Psychology of the University of Groningen, the Netherlands. In addition, she works as a clinical psychologist and behavioral therapist at the outpatient clinic for child and adolescent psychiatry of the University Medical Center. Her main research interests include treatment outcome research in youth, treatment response, assessment, etiology, and intergenerational factors in the field of anxiety, mood, and emotional disorders in youth.

Susan O’Brian works at the Australian Stuttering Research Centre, Faculty of Health Sciences, the University of Sydney. She has extensive experience in the field of stuttering treatment and research. Her major research interest is the effectiveness of early stuttering intervention in community settings. She also has published extensively in the area of adult stuttering treatment and stuttering measurement, and has developed mathematical methods for analysis of stuttering data for clinical trials.

Thomas G. O’Connor is Professor of Psychiatry and of Psychology and is Director of the Wynne Center for Family Research at the University of Rochester Medical Center. His research focuses on the mechanisms by which early stress exposure, both pre- and postnatal, alters bio-behavioral development in the child. He has been recipient of numerous research grants in the United States and United Kingdom and has received distinguished awards for his research. He also serves as an editor for the Journal of Child Psychology and Psychiatry.

William T. O’Donohue is widely recognized in the field for his proposed innovations in mental health service delivery, in treatment design and evaluation, and in knowledge of empirically supported cognitive behavior therapies. He is a member of the Association for the Advancement for Behavior. He has edited over 20 books, and written 35 book chapters and more than 75 articles in scholarly journals.

Mark O’Reilly is Mollie Villeret Davis Professor of Learning Disabilities at the University of Texas at Austin. His research focuses primarily on the assessment and treatment of challenging behavior, social skills training, and the design of assistive technology with persons with developmental disabilities.

Mark Onslow is the Foundation Director of the Australian Stuttering Research Centre, Faculty of Health Sciences, the University of Sydney. His background is speech pathology. He is a Principal Research Fellow of the National Health and Medical Research Council of Australia. His research interests are the epidemiology of early stuttering in preschoolers, mental health of those who stutter, measurement of stuttering, and the nature and treatment of stuttering.

Ann Packman works at the Australian Stuttering Research Centre, Faculty of Health Sciences, the University of Sydney. She has worked for more than 30 years in the area of stuttering as a clinician, teacher, and researcher. One of her current interests is theory of the cause of stuttering. She has cowritten a textbook on that topic, and has developed a theory of the cause of stuttering. She is the only Australian scientist to serve editorships of journals of the American Speech-Hearing Association.

Tonya M. Palermo is Professor of Anesthesiology and Pain Medicine at University of Washington School of Medicine and Seattle Children’s Hospital. She has published widely on sleep in youth with medical conditions, pediatric chronic pain management, and behavioral treatments for pain and sleep disturbances.

William E. Pelham Jr. is a Professor in the Department of Psychology at Florida International University and Director of the Center for Children and Families. He is also a Professor Emeritus in the Department of Psychology at the University at Buffalo–SUNY. His research focuses on developing and evaluating evidence-based practices for children and adolescents with attention-deficit/hyperactivity disorder (ADHD), especially psychosocial interventions.

Katrina J. Phillips is a senior tutor in the Department of Psychology, the University of Auckland, New Zealand. She has copublished on staff training and developmental and intellectual disabilities.

Cathleen C. Piazza received her PhD from Tulane University. She is Professor of Pediatrics and Director of the Pediatric Feeding Disorders Program at the University of Nebraska Medical Center in Omaha, and she previously directed similar programs at the Marcus Institute in Atlanta and at the Johns Hopkins University School of Medicine in Baltimore. Her research in the area of pediatric feeding disorders has been among the most systematic in the field and has firmly established behavioral approaches as preferred methods for assessment and treatment. Highly regarded for her general expertise in research methodology, Dr. Piazza just finished her tenure as editor of the Journal of Applied Behavior Analysis.

Stephen Pilling is Professor of Clinical Psychology and Clinical Effectiveness in the Research Department of Clinical, Health and Educational Psychology, University College London. He is the director of the National Collaborating Centre for Mental Health, which develops clinical practice guidelines for the National Institute for Health and Clinical Excellence. His research focuses on the evaluation of complex interventions for the treatment of severe mental illness, the development and evaluation of psychological treatments for depression, and the competences required to provide them effectively.

Antonio J. Polo is an Assistant Professor in the Department of Psychology at DePaul University in Chicago. Dr. Polo has been involved in school-based research for the past 15 years, primarily working with urban youth of African American and Latino backgrounds. His interests include understanding the social and cultural factors involved in the manifestation of youth internalizing and externalizing problems, particularly in immigrant and linguistic minority populations. His research also focuses on the delivery of evidence-based treatments for youth depression in community and practice settings and the retention and engagement of youth and their families in mental health care.

Glen O. Sallows is a Clinical Psychologist and Board Certified Behavior Analyst and president and cofounder of the Wisconsin Early Autism Project. He has taught at the University of Wisconsin and published and presented nationally and internationally in the areas of child treatment and treatment of autism spectrum disorders.

Megan Scott is a postdoctoral fellow in pediatric neuropsychology at Rainbow Babies and Children’s Hospital, University Hospitals of Cleveland, Ohio. Dr. Scott’s training background is in clinical assessment and treatment of children.

Jennifer R. Shapiro is a licensed clinical psychologist specializing in the treatment of eating disorders and obesity. She is currently the Scientific Director at Santech, Inc. in La Jolla, California, in which she applies for and directs research projects for the purpose of using the Internet and mobile technologies to enhance health conditions, particularly obesity. She has published numerous papers in the fields of eating disorders and obesity and annually presents at conferences.

Jeff Sigafoos is Professor of Educational Psychology at Victoria University of Wellington in New Zealand. He has published widely in the areas of special education provision, communication intervention, and evidence-based practice in the rehabilitation of individuals with developmental disabilities.

Mary Spagnola is a postdoctoral fellow in the Wynne Center for Family Research in the Department of Psychiatry, University of Rochester Medical Center. Her research focuses on family factors associated with behavioral adjustment and asthma symptoms.

Roger E. Thomas is Professor of Family Medicine, University of Calgary. He has published Cochrane systematic reviews on adolescent smoking and influenza vaccine. Other research interests are palliative care and child development problems.

Bruce J. Tonge is Professor of Psychological Medicine and Head of the Centre for Developmental Psychiatry and Psychology, School of Psychology and Psychiatry, Monash University, Australia. He has researched and published widely on mental health and intellectual disability, autism spectrum disorders, parent education and skills training, and the psychological and pharmacological treatment of anxiety and depression in children. He is coauthor of the Developmental Behaviour Checklist, a parent completed assessment of emotional and behavioral disorders in children, adolescents, and adults with Intellectual Disability.

Benjamin T. P. Tucker received his BA from St. Olaf College in 2007 with a major in psychology and a concentration in statistics. He completed his MS in clinical psychology at the University of Wisconsin-Milwaukee in the spring of 2010. He has coauthored several journal articles, book chapters, and presentations in these areas. He currently works as a behavior specialist for Tucci Learning Solutions in San Jose, California.

Valerie M. Volkert is an Assistant Professor and Director of the Pediatric Feeding Disorders Outpatient Program at the University of Nebraska Medical Center. She received a Bachelor’s of Science from the University of Florida, and her PhD in School Psychology from Louisiana State University in 2007. She has authored two book chapters and published 10 peer-reviewed research studies and she currently serves on the board of editors for the Journal of Applied Behavior Analysis.

Lisa Walton is an emerging researcher in health services based at the University of Auckland, School of Population Health, Auckland, New Zealand. She is completing a PhD in supportive care in gynecologic cancer and has an interest in evidence-based psychosocial interventions for people living with cancer.

Daniel A. Waschbusch is a Professor in the Center for Children and Families and in the Department of Psychology at Florida International University. His research focuses on developing and evaluating empirically based practices for children with conduct problems, attention-deficit/hyperactivity disorder (ADHD), and callous-unemotional traits.

T. Steuart Watson is Professor of Educational Psychology at Miami, Ohio University. His primary research interests include applied behavior analysis, direct behavioral consultation, and designing efficient, empirical treatments for academic and behavior problems in young children. He is coeditor of the Journal of Evidence-Based Practices for Schools and author of numerous refereed publications, book chapters, and books.

Tonya S. Watson is a Clinical Professor in Family Studies at Miami Ohio University. She is a licensed school psychologist and has worked extensively with families at risk for emotional/behavioral and academic problems. Her primary research and teaching interests include application of behavioral principles when working with children and their families and pediatric psychology.

Don E. Williams is a Behavioral Consultant in private practice at Richmond Behavioral Consulting in Richmond, Texas. He has published numerous articles on self-injurious behavior and other severe behavior disorders.

W. Larry Williams is the Director of the Behavior Analysis Program at the University of Nevada, Reno. After gaining his PhD from the University of Manitoba, he cofounded and directed the first graduate program in Special Education in Latin America, teaching over an 8-year period. He subsequently directed several clinical programs for persons with Intellectual Disabilities in Toronto, Canada, over a 10-year period. Having published several books and over 60 journal articles, he maintains a lab group with interests in conditional discrimination processes, relational framing, verbal behavior, clinical assessment, and interventions staff training and management systems.

Douglas W. Woods received his MS in Clinical Psychology from North Dakota State University and a PhD in Clinical Psychology from Western Michigan University. After completing an internship at the Nebraska Internship Consortium in 1999, Dr. Woods was hired on the faculty of the Clinical Psychology PhD program at the University of Wisconsin-Milwaukee, where he is now a Professor and Director of Clinical Training. Dr. Woods sits on the editorial board of six psychology journals. He is also a founding member of the Tourette Syndrome Association’s (TSA) Behavioral Sciences Consortium, is a member of TSA’s Medical Advisory Board, serves on the Scientific Advisory Board of the Trichotillomania Learning Center, and is an advisor to the Obsessive Compulsive-spectrum workgroup for DSM-5. He has authored or coauthored 130 papers or chapters, and authored or coauthored seven books on tic disorders, trichotillomania, and other repetitive behavior problems, and one on behavior analytic accounts of psychopathology. Dr. Woods has received over $2.5 million in extramural funding from the NIMH, TSA Grants program, Trichotillomania Learning Center Grants program.

Kristen Zychinski is a graduate student in the Clinical-Child Psychology doctoral program at DePaul University in Chicago. Her research interests include the development and treatment of internalizing problems in urban, ethnic minority youth. In particular, she studies the relationship between school factors, specifically academic achievement, and mental health in children and adolescents. Additionally, she is interested in developing and investigating evidence-based treatments designed to be effective for and accessible to underserved populations.

PART I

Overview and Foundational Issues

Chapter 1

Rationale and Standards of Evidence in Evidence-Based Practice

OLIVER C. MUDFORD, ROB MCNEILL, LISA WALTON, AND KATRINA J. PHILLIPS

What is the purpose of collecting evidence to inform clinical practice in psychology concerning the effects of psychological or other interventions? To quote Paul’s (1967) article that has been cited 330 times before November 4, 2008, it is to determine the answer to the question: “What treatment, by whom, is most effective for this individual with that specific problem, under which set of circumstances?” (p. 111). Another answer is pitched at a systemic level, rather than concerning individuals. That is, research evidence can inform health-care professionals and consumers about psychological and behavioral interventions that are more effective than pharmacological treatments, and to improve the overall quality and cost-effectiveness of psychological health service provision (American Psychological Association [APA] Presidential Task Force on Evidence-Based Practice, 2006). The most general answer is that research evidence can be used to improve outcomes for clients, service providers, and society in general.