Effectiveness of Cognitive-Behavioral Therapy for Children and Adolescents Under Routine Care Conditions in a University Outpatient Clinic As Rated by Parents

Background: There is a lack of studies examining the effectiveness of cognitive-behavioral therapy under routine care conditions. Objective: Changes in mental health problems of children and adolescents as rated by parents during outpatient therapy within a university clinic were examined. Psychologists or educationalists in advanced psychotherapy training provided all therapies. Therapists were guided by accredited supervisors for cognitive-behavioral therapy (one hour of supervision every fourth therapy session). Method: 976 completed treatments were analyzed with parent rating, using the Child Behavior Checklist's pre-post-comparisons. Effect sizes were computed and the clinical relevance of these changes was analyzed. Examinations were done for the whole sample and separately for youths that were rated within a clinical range by their parents at the beginning of treatment. Additionally, analyses for representativeness were calculated. Results: Within the complete sample, small to medium statistically significant decreases of mental health problems were observed. Youths who had been rated within clinical range by parent rating on the CBCL mainly showed large effect sizes. Neither could be explained by spontaneous changes or regression effects. It has to be noted that one quarter to one third of all patients were rated within a clinical range by their parents. Conclusions: These results show first hints of the effectiveness of cognitive-behavioral therapy of youths with mental health problems under routine care conditions. The results must be interpreted conservatively because of the lack of a control group.