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Clinician Perspectives of Diagnosis and Perceived Client Change in “Real World” Psychotherapy for Youth Emotional and Behavioral Disorders

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Abstract

We investigated the extent to which clinician-assigned diagnoses of emotional and behavioral disorders and clinicians’ perceptions of client change are consistent with structured measures of youth clinical functioning and parent/family characteristics within the context of usual care or “real world” psychotherapy. A total of 54 therapists from two publicly-funded youth outpatient mental health clinics and 128 youths and parents from the therapists’ combined caseloads were included in the study. Clinician-assigned diagnosis and youth and family demographics were collected at the initial visit, clinician-reported perceived client change was collected at 6-month follow-up, and structured measures of youth clinical functioning and parent/family characteristics were collected at both time points. Results indicate some overlap between clinician-assigned diagnosis, clinician-reported perceived client change, and structured measures of youth clinical functioning and parent/family characteristics after controlling for demographic factors. Results are discussed in terms of implications for the implementation of evidence-based practices in real world community settings.

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Acknowledgments

The first and second authors contributed equally to this article, which was supported by grants K01-MH-01544, R01-MH-66070, and R01-MH-066070-S1 from the National Institute of Mental Health. The authors would like to thank Caroline Lewczyk Boxmeyer, Ph.D. for her assistance in coordinating the study, Amanda Jensen Doss, Ph.D. for her thoughtful comments on an earlier version of the manuscript, Lindsay Lugo for her support in assembling the manuscript, and the clinicians and families for their participation.

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Authors and Affiliations

  1. Child & Adolescent Services Research Center, Rady Children’s Hospital, San Diego, 3020 Children’s Way MC 5033, San Diego, CA 92123, USA

    Rachel A. Haine

  2. Child & Adolescent Services Research Center, Department of Psychiatry, University of California, San Diego, CA, USA

    Lauren Brookman-Frazee & Ann F. Garland

  3. Department of Psychology, San Diego State University, San Diego, CA, USA

    Katherine H. Tsai & Scott C. Roesch

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  1. Rachel A. Haine
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  2. Lauren Brookman-Frazee
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  4. Scott C. Roesch
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  5. Ann F. Garland
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Correspondence to Rachel A. Haine.

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Haine, R.A., Brookman-Frazee, L., Tsai, K.H. et al. Clinician Perspectives of Diagnosis and Perceived Client Change in “Real World” Psychotherapy for Youth Emotional and Behavioral Disorders. J Child Fam Stud 16, 712–728 (2007). https://doi.org/10.1007/s10826-006-9118-x

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  • DOI: https://doi.org/10.1007/s10826-006-9118-x

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