CHILD AND ADOLESCENT PSYCHOTHERAPY OUTCOMES IN EXPERIMENTS VERSUS CLINICS - WHY THE DISPARITY

In a recent article, Weisz, Weiss, and Donenberg (1992) compared the e ffects of child and adolescent psychotherapy in experimental studies a nd in studies of clinic practice. Here we update that report with new information and we explore 10 possible reasons why, to date, therapy i n experiments appears to have shown larger effect sizes than therapy i n clinics. We find that beneficial therapy effects are associated with three factors which are more common in research therapy than in clini c therapy: (a) the use of behavioral (including cognitive-behavioral) methods, (b) reliance on specific, focused therapy methods rather than mixed and eclectic approaches, and (c) provision of structure (e.g., through treatment manuals) and monitoring (e.g., through review of the rapy tapes) to foster adherence to treatment plans. These three factor s all involve dimensions along which clinic procedures could be altere d.