Annual Research Review: Expanding mental health services through novel models of intervention delivery
Abstract
Currently, in the United States and worldwide, the vast majority of children and adolescents in need of mental health services receive no treatment. Although there are many barriers, a key barrier is the dominant model of delivering psychosocial interventions. That model includes one‐to‐one, in‐person treatment, with a trained mental health professional, provided in clinical setting (e.g., clinic, private practice office, health‐care facility). That model greatly limits the scale and reach of psychosocial interventions. The article discusses many novel models of delivering interventions that permit scaling treatment to encompass children and adolescents who are not likely to receive services. Special attention is accorded the use of social media, socially assistive robots, and social networks that not only convey the ability to scale interventions but also encompass interventions that depart from the usual forms of intervention that currently dominate psychosocial treatment research.
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This change is predicted to alleviate many barriers that stand in the way of people seeking or receiving treatment under the current model of health care delivery (e.g., insufficient number of trained professionals, geographical constraints, lack of anonymity), thereby vastly increasing the availability of psychological therapies.
“This change is predicted to alleviate many barriers that stand in the way of people seeking or receiving treatment under the current model of health care delivery (e.g., insufficient number of trained professionals, geographical constraints, lack of anonymity), thereby vastly increasing the availability of psychological therapies 3,4 .”
From The efficacy of app-supported smartphone interventions for mental health problems: a meta-analysis of randomized controlled trials (2019) · cites this paper as [4]
Internet interventions are easily scalable and offer help at a low threshold and with high confidentiality and privacy.
“They are easily scalable and offer help at a low threshold and with high confidentiality as well as privacy [2, 39].”
From Efficacy of a transdiagnostic Internet prevention approach in adolescents (EMPATIA study): study protocol of a randomized controlled trial (2024) · cites this paper as [39]
Many adolescents in need of care remain untreated (the care gap).
“many adolescents in need of care who nevertheless remain untreated (known as the “care gap”) [24, 39, 40]”
From Efficacy of a transdiagnostic Internet prevention approach in adolescents (EMPATIA study): study protocol of a randomized controlled trial (2024) · cites this paper as [39]
Barriers for the dissemination of MBIs are similar to those facing other evidence-based psychotherapies (eg, lack of available providers, cost, logistical challenges).
“Barriers for the dissemination of MBIs are similar to those facing other evidence-based psychotherapies (eg, lack of available providers, cost, logistical challenges) [23-25].”
From Testing the efficacy of a multicomponent, self-guided, smartphone-based meditation app: Three-armed randomized controlled trial (2020) · cites this paper as [25]
The coach need not be a highly qualified therapist.
“we argue that the coach need not be a highly qualified therapist (Gonsalves et al., 2021; Kazdin, 2019).”
From Intervention for school anxiety and absenteeism in children (ISAAC): Co-designing a brief parent-focused intervention for emotionally-based school avoidance. (2024) · cites this paper as Kazdin, 2019
Kazdin (2019) argues that the need-to-access gap is unlikely to change until there is a significant shift away from interventions requiring a face-to-face format and delivery by an expert with extensive training.
“Kazdin (2019) argues that this need-to-access gap is unlikely to change until there is a significant shift away from interventions requiring a face-to-face format and delivery by an “expert” with extensive training.”
From Intervention for school anxiety and absenteeism in children (ISAAC): Co-designing a brief parent-focused intervention for emotionally-based school avoidance. (2024) · cites this paper as Kazdin, 2019
Many young people who experience psychological symptoms do not receive support even in usual circumstances.
“The increased need for support is especially troubling, given that many young people who experience psychological symptoms do not receive support even in usual circumstances (Kazdin, 2019).”
From Brief online ACT intervention to improve adolescents' well-being: Effectiveness among adolescents with depressive symptoms during COVID-19. (2024) · cites this paper as Kazdin, 2019
Schools play a central role in identifying the need for support among young people but have access to limited resources to respond to that need.
“As schools play a central role in identifying the need for support among young people but have access to limited resources to respond to that need, online interventions may offer novel solutions and reach more adolescents (Kazdin, 2019).”
From Brief online ACT intervention to improve adolescents' well-being: Effectiveness among adolescents with depressive symptoms during COVID-19. (2024) · cites this paper as Kazdin, 2019
Traditional face-to-face mental health care had many limitations, such as expensive treatment, lack of experienced therapists, poor service quality, geographical constraints, and delayed treatment.
“This was because traditional face-to-face mental health care still had many limitations, such as expensive treatment, lack of experienced therapists, poor service quality, geographical constraints, and delayed treatment [7,8]”
From Conversational Agent Interventions for Mental Health Problems: Systematic Review and Meta-analysis of Randomized Controlled Trials (2023) · cites this paper as [7]
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“However, remaining mindful of both the preferences of our participants and the necessity of moving away from intervention models that rely on access to “ experts ” , we argue that the coach need not be a highly quali fi ed therapist (Gonsalves et al., 2021; Kazdin, 2019).”
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“This results in both low treatment rates of 38% for any mental disorder in this age group [38] and many adolescents in need of care who nevertheless remain untreated (known as the “care gap”) [24, 39, 40].”
Background
- Authors
- Kazdin, A. E.
- Affiliations
- Yale University (US)
- Corresponding author
- Kazdin, Alan E.
- ORCID
- Kazdin, Alan E.
- Venue
- Journal of Child Psychology and Psychiatry
- Publisher
- Wiley
- Published
- 2018-06-13
- Volume
- 60
- Issue
- 4
- Pages
- 455-472
- ISSN
- 0021-9630 (ISSN-L)
- 1469-7610
- OpenAlex
- W2807797244
- Cited by
- 274
- References
- 132
- Citations by year
- 2026: 27 · 2025: 41 · 2024: 36 · 2023: 45 · 2022: 43 · 2021: 37 · 2020: 32 · 2019: 12 · 2018: 1
- FWCI
- 2.79
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Child Psychology and Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Health Resources and Services Administration
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Keywords
- mental health services, children and adolescents, psychosocial interventions, social media, socially assistive robots, social networks, access to mental health care
- MeSH terms
- Adolescent, Mental Disorders, Child, Delivery of Health Care, Humans, Mental Health Services, Psychotherapy, Models, Organizational, Social Media
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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