Study 1
Weisz and colleagues (2012) used a cluster randomization design to assign 84 therapists, from 10 different outpatient community- and school-based settings in Massachusetts and Hawaii, to one of three study conditions: 1) standard manualized treatment condition; 2) modular condition (MATCH-ADTC); and 3) usual care. The CrimeSolutions review of this study focused on the comparisons between the modular condition and usual care (see Other Information for further details). Therapists were assigned using blocked randomization stratified by their educational level (doctoral versus master?s degree). Participating youths had all sought outpatient care and had primary clinical concerns involving either a diagnosis of anxiety, depression, or disruptive conduct disorders, or they showed clinical elevations in any of these areas.
Clinicians randomized to the modular treatment group used a collection of 31 modules from MATCH-ADTC that corresponded to three manualized treatment protocols: Coping Cat for anxiety, Primary and Secondary Control Enhancement Training (PACET) for depression, and Defiant Children for disruptive conduct and noncompliant behavior, in addition to guiding algorithms for their use. Clinicians randomized to the usual care group used their normal treatment procedures.
The full sample consisted of 174 youths ages 7 to 13 years old, with a mean age of 10.6 years. There were 69 youths in the standard condition, 70 youths in the modular condition, and 64 youths in the usual care condition. Demographic information was provided for the overall study sample, although the comparison of interest for this CrimeSolutions review is the modular condition compared with the usual care condition. The majority of the participants were boys (70 percent) and white (45 percent) or multiethnic (32 percent). The remaining sample was African American (9 percent), Latino/Latina (6 percent), Asian American/Pacific Islander (4 percent), and other (2 percent). The most common diagnoses were conduct-related disorder (42.5 percent), anxiety disorder (29.3 percent), and mood disorder (16.7 percent).
Child and caregiver versions of the Top Problems Assessment were used to assess the severity of the top three problems of greatest clinical concern to youths and their caregivers. Assessors blind to study condition conducted assessments at baseline and post-treatment, and at several time points in between. To measure the effect of the intervention on the problems of greatest clinical concern, mixed effects regression models were estimated.
Study 2
Chorpita and colleagues (2013) used the data gathered as part of the randomized controlled trial from Weisz and colleagues (2012), described above. The 2013 study extends the original 2012 study by examining different outcome measures.
For the outcomes of interest, the Child Behavior Checklist and Youth Self-Report were used for caregivers and youths, respectively, to assess the youths? emotional and behavioral symptoms (internalizing and externalizing problems). Caregivers also reported on the youths? functional impairment across three domains: interpersonal relations, school, and self-care, using the Brief Impairment Scale. Assessors blind to study condition conducted assessments at baseline, 24 months following study enrollment, and at several time points in between. To measure the effect of the MATCH-ADTC intervention on internalizing problems, externalizing problems, and functioning, mixed effects regression models were estimated. There were no subgroup analyses.
Study 3
Chorpita and colleagues (2017) used a cluster randomization design with 50 therapists from three different community agencies in low-income urban settings in Los Angeles County and San Bernardino County. Therapists were assigned to either the MATCH-ADTC treatment group or the community-implemented treatment control group using blocked randomization. Participating youths were referred to their local public mental health agency and had primary clinical concerns involving anxiety, depression, disruptive behavior, or traumatic stress.
Clinicians randomized to the modular treatment group used MATCH-ADTC. Clinicians randomized to the community-implemented control condition used treatment procedures as they normally would in the context of county-mandated use of evidence-based treatments.
This 2017 study differed from the 2012 and 2013 studies (described above) in that it included use of all 33 modules within MATCH-ADTC in the analysis of effectiveness. The earlier studies did not include a comparison condition for a manualized trauma treatment; therefore, the two trauma-specific modules of MATCH-ADTC were omitted.
The analytic sample included 138 youths ages 5 to 15 years old, with a mean age of 9.3 years. Of those, 78 youths were assigned to the intervention group, and 60 were assigned to the community-implemented treatment control group. Just over half (55.1 percent) were boys. The majority of the sample was Latino/a (78.3 percent), followed by 10.1 percent African American, 8.0 percent multiethnic, and 3.6 percent white. The most common focus of primary concern was conduct/disruptive behavior (43.5 percent), followed by depression (28.3 percent), and anxiety (27.5 percent).
Child and caregiver versions of the Brief Problem Checklist were used to assess internalizing and externalizing problems. Child and caregiver versions of the Top Problems Assessment were used to assess the severity of the problems of greatest clinical concern to youths and their caregivers. Assessors blind to study condition conducted assessments at baseline and posttreatment, and on a weekly basis during the course of the treatment. To measure the effect of the intervention on internalizing problems, externalizing problems, and the problems of greatest clinical concern, mixed effects regression models were estimated. There were no subgroup analyses.