(PS5-D86) Modular Youth Psychotherapy: A Systematic Review of Treatment Measures and Outcomes

Background: Modular youth psychotherapies are defined by their independent components, flexible sequencing, and frequent decisions around personalizing for client needs (Chorpita et al., 2005; Venturo-Conerly et al., 2023). These therapies have grown in popularity over the last 15 years, with considerable relevant research published. In this systematic review, we assess how many of the youth modular psychotherapies have been trialed, using which outcome measures, and what the clinical outcomes have been.

Methods: Articles identified in a scoping review (n = 67 articles; 20 modular psychotherapy protocols; Venturo-Conerly et al., 2023) were further examined for treatment outcomes if they presented data from a randomized controlled trial (RCT) or open trial. Measures must have been collected both before and after treatment and must have assessed symptoms (rather than satisfaction or feasibility measures).

Results: Of 31 studies that met these criteria, 24 (77.4%) were RCTs, and 7 (22.6%) were open trials. Of the 20 modular treatment protocols, 15 were tested in at least one published trial identified in the scoping review.

Of the 24 included RCTs, 15 (62.5%) included treatment outcomes for internalizing and externalizing problems (e.g. Child Behavior Checklist), 14 (58.3%) for anxiety or depression symptoms (e.g. Revised Children’s Anxiety and Depression Scale), and 14 (58.3%) for the presence or severity of DSM-V diagnoses (e.g. clinician’s severity rating). Functional impairment was measured by 9 studies (37.5%). Autism spectrum disorder symptom measures were collected by 6 (25.0%) studies, conduct measures by 4 (16.7%), and child well-being or quality of life by 3 (12.5%) studies; post-traumatic stress symptoms, frequency of maladaptive cognitions, and tic symptoms were examined by one study each.

Of the identified RCTs, 15 (62.5%) showed statistically significant clinical benefit of the examined modular treatment. Five (20.8%) showed mixed results (e.g. unreliable findings due to missing data, significant results for limited outcomes). Four (16.7%) showed no significant effects relative to the control group. Multiple studies reported limitations related to small sample sizes and lack of active control condition. Next steps on this project will involve breaking down the clinical effectiveness data by measure type across the RCTs.

Discussion: While the effectiveness of youth modular psychotherapies has been examined across a multitude of treatment outcomes, more data is needed to understand the impact of specific clinician decisions on these outcomes. Modular psychotherapy effectiveness may vary across decisions made about duration of treatment, child and parent involvement in decision-making, target problems, and module selection and sequencing. A key goal of modular psychotherapies is to optimize client outcomes by tailoring treatment to each individual (Venturo-Conerly et al., 2023). Accomplishing this goal necessitates further research on how the characteristics of modular treatments (e.g., specific modules, type of decision-making guidance, adherence to this guidance) impact youth treatment outcomes.