Youth Interventions Summary by Bente Niemeijer
Introduction lecture and tutorials
Characteristics of youth interventions
• Embedded in the environment (parents, school,…)
• Problems arise in transaction with the environment
• Interventions are often focused on the environment
• Problem awareness of involved parties may differ
• Children are not always motivated
• You have to take development into account
• Typical development: what is typical for this phase of life?
• Atypical development: when does it become atypical or psychopathology?
Levels of youth interventions
• Prevention:
• Universal – focused on whole population
• Selective – focused on youth with certain risk
• Indicated – focused on youth already showing symptoms
• Treatment:
• Symptoms at subclinical level
• Symptoms at clinical level (DSM diagnosis)
Ef cacy and effectiveness
• Evidence-based interventions: interventions for which there is (some) evidence concerning
efficacy and effectiveness
• Guidelines have been developed by the American Psychological Association (US) and Dutch
Youth Institute (NJI)
• Many of the interventions that are currently delivered are not evidence-based
• It is important to gain insight into the most effective components of a treatment
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, Youth Interventions Summary by Bente Niemeijer
Research strategies to discern active psychological therapy components
• Strategy 1 - expert opinion: ask therapists what they think are the most effective elements of
interventions.
• Strengths: feasible + brings in diverse opinions in different context, which helps with
generalisability.
• Limits: it will be a very long list + potential lack of empirical evidence for expert opinions
• Strategy 2 - identifying common elements: identifying shared components of effective
interventions
• Strengths: feasible + includes wide range of therapies and outcomes, which helps with
generalisability.
• Limits: lack of ability to draw causal conclusions about shared components and outcomes
• Strategy 3 - compare effects of interventions with versus without component: test wether
therapy effects are larger in patients who receive the target component
• Strengths: integrating information from range of therapies helps with generalisability. Also
helps to narrow down the list of shared components by removing components that aren’t
associated with therapy effects.
• Limits: 3rd variable confound problem due to lack of randomisation.
• Strategy 4 - compare components with high versus low delity: testing wether therapy effects
are larger in patients who receive the target component as implement with greater fidelity
• Strengths and limits: same as previous strategy
• Strategy 5 - microtrials: offer only the one component that you think is effective and see what
the outcome is
• Strengths: experimental design, so you can make causal conclusions. More feasible, requires
fewer resources
• Limits: lack of generalisability due to isolation of components
• Strategy 6 - additive/dismantling studies: testing the effect of implementing a complete
therapy protocol with the target component versus the same therapy without the target
component
• Strengths: experimental design + evaluate components within treatment protocol →
generalisable
• Limits: poor statistical power, higher risk of type 2 errors (false negative) and costly
• Strategy 7 - factorial experiments: testing the single and additive/synergistic effects of
components by randomly assigning participants to receive any possible combination of target
components.
• Strengths: casuals conclusions + can test multiple components
• Limits: risk of contagion of therapy content across conditions
fi
Introduction lecture and tutorials
Characteristics of youth interventions
• Embedded in the environment (parents, school,…)
• Problems arise in transaction with the environment
• Interventions are often focused on the environment
• Problem awareness of involved parties may differ
• Children are not always motivated
• You have to take development into account
• Typical development: what is typical for this phase of life?
• Atypical development: when does it become atypical or psychopathology?
Levels of youth interventions
• Prevention:
• Universal – focused on whole population
• Selective – focused on youth with certain risk
• Indicated – focused on youth already showing symptoms
• Treatment:
• Symptoms at subclinical level
• Symptoms at clinical level (DSM diagnosis)
Ef cacy and effectiveness
• Evidence-based interventions: interventions for which there is (some) evidence concerning
efficacy and effectiveness
• Guidelines have been developed by the American Psychological Association (US) and Dutch
Youth Institute (NJI)
• Many of the interventions that are currently delivered are not evidence-based
• It is important to gain insight into the most effective components of a treatment
fi
, Youth Interventions Summary by Bente Niemeijer
Research strategies to discern active psychological therapy components
• Strategy 1 - expert opinion: ask therapists what they think are the most effective elements of
interventions.
• Strengths: feasible + brings in diverse opinions in different context, which helps with
generalisability.
• Limits: it will be a very long list + potential lack of empirical evidence for expert opinions
• Strategy 2 - identifying common elements: identifying shared components of effective
interventions
• Strengths: feasible + includes wide range of therapies and outcomes, which helps with
generalisability.
• Limits: lack of ability to draw causal conclusions about shared components and outcomes
• Strategy 3 - compare effects of interventions with versus without component: test wether
therapy effects are larger in patients who receive the target component
• Strengths: integrating information from range of therapies helps with generalisability. Also
helps to narrow down the list of shared components by removing components that aren’t
associated with therapy effects.
• Limits: 3rd variable confound problem due to lack of randomisation.
• Strategy 4 - compare components with high versus low delity: testing wether therapy effects
are larger in patients who receive the target component as implement with greater fidelity
• Strengths and limits: same as previous strategy
• Strategy 5 - microtrials: offer only the one component that you think is effective and see what
the outcome is
• Strengths: experimental design, so you can make causal conclusions. More feasible, requires
fewer resources
• Limits: lack of generalisability due to isolation of components
• Strategy 6 - additive/dismantling studies: testing the effect of implementing a complete
therapy protocol with the target component versus the same therapy without the target
component
• Strengths: experimental design + evaluate components within treatment protocol →
generalisable
• Limits: poor statistical power, higher risk of type 2 errors (false negative) and costly
• Strategy 7 - factorial experiments: testing the single and additive/synergistic effects of
components by randomly assigning participants to receive any possible combination of target
components.
• Strengths: casuals conclusions + can test multiple components
• Limits: risk of contagion of therapy content across conditions
fi
