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Administration and policy in mental health
03, 2021;48 (2): 219-232.

Practices Derived from the Evidence Base for Depression Predict Disruptive Behavior Progress in Adolescent Community Mental Health Care.

Daniel P Wilkie, Charles W Mueller
Author Information
  1. Daniel P Wilkie: Department of Psychology, University of Hawai`i at Mānoa, 2530 Dole Street, Sakamaki C400, Honolulu, HI, 96822, USA. dpwilkie@hawaii.edu. ORCID
  2. Charles W Mueller: Department of Psychology, University of Hawai`i at Mānoa, 2530 Dole Street, Sakamaki C400, Honolulu, HI, 96822, USA.
PMID: 32661788 DOI: 10.1007/s10488-020-01068-5

Abstract

Disruptive behavior problems develop along multiple causal pathways and are associated with a wide variety of co-occurring problems, including mood disorders. In usual care, effective treatment practices for youth disruptive behavior might differ from what the efficacy research suggests, given treatment setting and population demographic differences. The current study examined whether practices derived from the evidence base for disruptive behavior and/or depressed mood predicted progress on disruptive behavior problems in an adolescent usual care sample. Monthly clinical data, including therapeutic practices, treatment targets, and progress on selected treatment targets, for 1210 youth ages 13-17 who received intensive in-home services and were treated for disruptive behavior problems were examined utilizing multilevel modeling techniques. Practices derived from the evidence base for only depressed mood and practices derived from both disruptive behavior and depressed mood literatures predicted disruptive behavior progress, while practices derived from only the disruptive behavior evidence-based literature did not. All five practice elements exclusive to depressed mood treatment predicted positive disruptive behavior progress, while two of eleven disruptive behavior practices and four of seven practices derived from both problem areas predicted positive progress. Findings held when other predictors were included as covariates, including youth age and functional impairment. Although directionality remains unclear and further research is vital, usual care settings might present barriers to disruptive behavior treatment as prescribed by the evidence base, and youth-focused treatments based on depressed mood treatments merit further examination as a potentially promising route to effective treatment in such settings.

Keywords

Children's mental health Depression Disruptive behavior Irritability Practice elements Usual care

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MeSH Term

Adolescent
Community Mental Health Services
Depression
Humans
Mental Health
Mood Disorders
Problem Behavior
Journal Article Research Support, Non-U.S. Gov't

Word Cloud

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