Review: comprehensive treatments for youth comorbidity – evidence-guided approaches to a complicated problem
Open accessAbstract
BACKGROUND: Evidence-based treatments (EBTs) with a single-disorder focus have improved the potential for youth mental health care, yet may be an imperfect fit to clinical care settings where diagnostic comorbidity and co-occurring problems are commonplace. Most EBTs were developed to treat one diagnosis or problem (or a small homogenous cluster), but most clinically referred youths present with multiple disorders and problems. FINDINGS: Three emerging approaches may help address the comorbidity that is so common in treated youths. Conceptually unified treatments target presumed causal and maintaining factors that are shared among more than one disorder or problem area; preliminary open trials and case studies show promising results. Modular protocols combine the 'practice elements' that commonly appear in separate single-disorder EBTs and repackage them into coordinated delivery systems; one modular protocol, MATCH, has produced positive findings in a randomized effectiveness trial. Monitoring and Feedback Systems (MFSs) provide real-time data on client progress to inform clinical decision-making, encompassing comorbid and co-occurring problems; one study shows beneficial effects in everyday practice with diverse youth problems. CONCLUSIONS: All three approaches - conceptually unified, modular, and MFS - can be strengthened by increased research attention to treatment integrity, clinician user-appeal, design simplicity, and the infrastructure necessary for successful implementation.
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A broad range of evidence-based psychosocial interventions are not being routinely delivered.
“a broad range of evidence-based psychosocial interventions are not being routinely delivered (Bearman and Weisz, 2015; Weisz, 2015).”
From An Emotion Regulation and Impulse Control (ERIC) Intervention for Vulnerable Young People: A Multi-Sectoral Pilot Study (2021) · cites this paper as Bearman and Weisz, 2015
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Lucassen, M. F. G., Stasiak, K., Crengle, S. M., Weisz, J. R., FRAMPTON, C. M. A., Bearman, S. K., Ugueto, A. M., Herren, J. A., Cribb-Su’a, A., Faleafa, M., et al. (2015) · Trials · doi:10.1186/s13063-015-0982-9 · Cited by 35 · see citing works
Self-citationSloan, E., Hall, K., Simpson, A., Youssef, G. J., Moulding, R., Mildred, H., & Staiger, P. K. (2018) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2017.12.006 · Cited by 30 · see citing works
Livheim, F., Tengström, A., Andersson, G., Dahl, J., Björck, C., & Rosendahl, I. (2020) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2020.03.008 · Cited by 29 · see citing works
School Counselor Perspectives on Implementing a Modular Treatment for Youth
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Hall, K., Youssef, G., Simpson, A., Sloan, E., Graeme, L., Perry, N., Moulding, R., Baker, A. L., Beck, A. K., & Staiger, P. K. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.554100 · Cited by 17 · see citing works
“Referred to as the “quality chasm” (Institute of Medicine, 2006), a broad range of evidence-based psychosocial interventions are not being routinely delivered (Bearman and Weisz, 2015; Weisz, 2015).”
BackgroundSocratic questions with children: Recommendations and cautionary tales.
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Nguyen, A. J., Hersh, J., Beahm, L. A., Smith, L. H., Newman, C., Birchfield, K., Michael, K. D., & Bradshaw, C. P. (2024) · School Mental Health · doi:10.1007/s12310-024-09632-2 · Cited by 12 · see citing works
Herpers, P. C. M., Neumann, J. E. C., & Staal, W. (2020) · Child Psychiatry & Human Development · doi:10.1007/s10578-020-01036-y · Cited by 11 · see citing works
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Friedberg, R. D., & Thordarson, M. A. (2017) · Autism and child psychopathology series · doi:10.1007/978-3-319-71210-9_4 · Cited by 7 · see citing works
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Child and adolescent psychotherapy
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Training Clinical Staff in Genuine CBT: One Large Agency’s Preliminary Story
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Fuggle, P., & Cleridou, K. (2016) · Child and Adolescent Mental Health · doi:10.1111/camh.12199
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Sloan, E. (2018) · Own your potential (DEAKIN)
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Gouze, K. R., Hopkins, J., & Lavigne, J. V. (2025) · Springer eBooks · doi:10.1007/978-3-032-04680-2_12
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Njarðvík, U. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-29009-1.00097-4
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Self-citation
- Authors
- Bearman, S. K., & Weisz, J. R.
- Affiliations
- The University of Texas at Austin (US)
- Harvard University (US)
- Corresponding author
- Bearman, Sarah Kate
- Venue
- Child and Adolescent Mental Health
- Publisher
- Wiley
- Published
- 2015-03-27
- Volume
- 20
- Issue
- 3
- Pages
- 131-141
- ISSN
- 1475-357X (ISSN-L)
- 1475-3588
- PMC
- PMC4574497
- OpenAlex
- W2013294621
- Cited by
- 48
- References
- 89
- Citations by year
- 2026: 5 · 2025: 1 · 2024: 3 · 2023: 7 · 2022: 2 · 2021: 3 · 2020: 7 · 2019: 5 · 2018: 3 · 2017: 5 · 2016: 5 · 2015: 2
- FWCI
- 0.72
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Child and Adolescent Mental Health (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (MH083887)
- The Annie E. Casey Foundation
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- youth mental health, co-occurring problems, evidence-based treatment, implementation fidelity, implementation
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