Clinician-Reported Modification to a CBT Approach in Children’s Mental Health
Abstract
Examining the nature and determinants of evidence-based treatment (EBT) modification is an important step toward understanding the impact of modifications and informing modification guidelines. We examined the prevalence, types, reasons for, and predictors of clinician-reported modification to cognitive behavioral therapy (CBT) for children and adolescents. Ninety-eight clinicians trained in CBT completed surveys on their intent to modify CBT, perceptions of CBT characteristics, confidence in their ability to appropriately deliver CBT in complex clinical situations, and organizational EBT implementation climate post-training. Post-consultation, clinicians self-reported the types and reasons for modifications they performed. Ninety-three percent of clinicians reported they modified CBT, primarily with fewer than half of their clients. Client needs and clinician preference or style accounted for the highest proportion of modification reasons. The number of reported modifications performed was predicted by clinician confidence in their ability to deliver CBT appropriately ( b = .90, p = .01) and their intent to modify ( b = .55, p = .01).
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Providers of psychosocial interventions frequently modify interventions for a variety of reasons, including perceived client preferences, providers' preferences or self-efficacy, and efforts to maintain a good therapeutic alliance.
“Providers of psychosocial interventions frequently modify interventions for a variety of reasons, including perceived client preferences, providers’ preferences or self-efficacy [54], and efforts to maintain a good therapeutic alliance [55–58].”
From The FRAME: an expanded framework for reporting adaptations and modifications to evidence-based interventions (2019) · cites this paper as [54]
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“self-efficacy [54], and efforts to maintain a good therapeutic alliance [55–58].”
BackgroundSelf-citation
- Authors
- Meza, R. D., Jungbluth, N., Sedlar, G., Martin, P., Berliner, L., Wiltsey-Stirman, S., & Dorsey, S.
- Affiliations
- University of Washington (US)
- Stanford University, CA, USA
- Corresponding author
- Meza, Rosemary D.
- ORCID
- Venue
- Journal of Emotional and Behavioral Disorders
- Publisher
- SAGE Publications
- Published
- 2019-02-13
- Volume
- 28
- Issue
- 2
- Pages
- 104-113
- ISSN
- 1063-4266 (ISSN-L)
- 1538-4799
- OpenAlex
- W2913407985
- Cited by
- 11
- References
- 12
- Citations by year
- 2024: 1 · 2023: 3 · 2022: 4 · 2021: 1 · 2019: 2
- FWCI
- 2.05
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Emotional and Behavioral Disorders (publishedVersion)
- Funders
- Washington State Department of Social and Health Services, Division of Behavioral Health Recovery
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- cognitive behavioral therapy, treatment modification, evidence-based practice, children and adolescents, clinician confidence, implementation climate, customer needs, clinician preferences, child mental health
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