Toward a level playing field: Predictive factors for the outcomes of mental health treatment for adolescents

Objective: To understand better the effectiveness of routine treatment for emotional and behavioral problems experienced by adolescents, methods are n eeded to control for between-provider differences in the distribution of fa ctors that adversely affect treatment success. Such methods are necessary t o fairly compare providers' outcomes and to aid clinicians in identifying a dolescents for whom routine care may need to be altered. As a preliminary s tep toward developing a model to adjust treatment outcomes to account for p redictive factors, findings from studies of treated samples of adolescents were reviewed to identify the factors that influence the likelihood of trea tment success for this population. Method: Medline and PSYCInfo databases w ere searched for studies of treated adolescents that reported the associati on between expert-nominated predictive factors and outcomes. Thirty-four st udies met inclusion criteria. Results: Significant predictors identified in these studies include diagnosis, baseline severity of symptoms and functio nal impairment, family dysfunction, and previous treatment. Several expert- nominated factors have not been adequately studied in treated samples. Conc lusions: Much basic work is needed before a convincing body of empirical ev idence can explain predictive factors for adolescent mental health treatmen t outcomes. Future efforts should determine a reduced set of predictive fac tors that can be measured with minimal burden to providers.