Evaluation of indicated preventive intervention (secondary prevention) mental health programs for children and adolescents

Evaluated the outcomes of 130 indicated preventive interventions (secondary prevention) mental health programs for children and adolescents that seek to identify early signs of maladjustment and to intervene before full-blown disorders develop. Results indicate such programs significantly reduce pro blems and significantly increase competencies. In particular behavioral and cognitive-behavior programs for children with subclinical disorders (mean ESs in the 0.50s) appear as effective as psychotherapy for children with es tablished problems and more effective than attempts to prevent adolescent s moking, alcohol use, and delinquency. In practical terms the average partic ipant receiving behavioral or cognitive-behavior intervention surpasses the performance of approximately 70% of those in a control group. Of particula r interest was the high mean effect (0.72) achieved by programs targeting i ncipient externalizing problems which are customarily the least amenable to change via traditional psychotherapeutic efforts when they reach clinical levels. priorities for future research include greater specification of int ervention procedures, assessment of treatment implementation, more follow-u p studies, and identifying how different participants respond to early inte rvention.