4 - (IOP 30) When Common Elements Are Not Always Common: A Descriptive Visualization of Mental Health Treatment Practices for Youth

Over the past two decades, there has been a monumental push toward evidence-based practice that integrates the best available research, clinical expertise, and client characteristics. Although an increasing number of contextually-sensitive mental health treatments have been developed and tested, their packaging obscures what practices are included in effective treatments for which groups. By distilling common practice elements from evidence-based treatments and matching these practice element profiles to client characteristics, the distillation and matching model offers a unique methodology for promoting evidence-based practice. This study applied the distillation and matching model to 818 randomized clinical trials testing mental health treatments for children and adolescents. Eighty-three practice elements were distilled from descriptions of 974 treatments and then profiles of practice elements were matched with client problem, age, gender, and ethnicity/race codified from sample descriptions. Using various programs written in Python version 3.7.4 and SQL, we explored when the youth mental health treatment literature indicated that client characteristics mattered, and if so, in what way (e.g., effective treatments for one group more often included Practice A, whereas effective treatments for another group more often included Practice B). We generated more than a dozen visualizations of the youth mental health treatment literature that show where important differences in practice element profiles emerged, and which specific practice elements were relevant in those contrasts. For example, different practice element profiles emerged across youth anxiety, aggression, oppositionality, inattention and hyperactivity, depression, autism, substance use, traumatic stress, justice involvement, anger, and school refusal. Examples of relevant practice elements include exposure for anxiety, tangible rewards for inattention and hyperactivity, social skills training for autism, motivational enhancement for substance use, relaxation for traumatic stress, family therapy for justice involvement, behavioral contracting for anger, and differential reinforcement for school refusal. Effective treatments targeting externalizing problems in multiethnic youth, children, and adolescents featured different practice element profiles. Age also influenced the practice composition of effective treatments for depression. Additionally, effective treatments for American Indian and Alaska Native youth more often included problem solving, communication skills, and family therapy. Findings indicate that the practice composition of effective treatments differs across client problems, ages, and ethnic/racial groups and provide an instrumental map of what practices matter for which groups.